Risultati per: Nuovo test per distinguere tra infezioni virali e batteriche

La tendenza potrebbe proseguire per tutto l’inverno

Migliora la memoria e riduce la stanchezza

This cohort study among patients with cancer examines changes in the time from posting of test results in the electronic health record to patient viewing in the patient portal before and after implementation of the 21st Century Cures Act.

In 2021, the US saw an estimated 1.6 million chlamydia cases and more than 700 000 gonorrhea cases.

Ministero, per l’accesso agli ospedali. Tampone per entrare nelle Rsa

Objectives
The study aim was to evaluate vaccine effectiveness (VE) of COVID-19 vaccines in preventing symptomatic COVID-19 among healthcare workers (HCWs) in Zambia. We sought to answer the question, ‘What is the vaccine effectiveness of a complete schedule of the SARS-CoV-2 vaccine in preventing symptomatic COVID-19 among HCWs in Zambia?’

Design/setting
We conducted a test-negative case–control study among HCWs across different levels of health facilities in Zambia offering point of care testing for COVID-19 from May 2021 to March 2022.

Participants
1767 participants entered the study and completed it. Cases were HCWs with laboratory-confirmed SARS-CoV-2 and controls were HCWs who tested SARS-CoV-2 negative. Consented HCWs with documented history of vaccination for COVID-19 (vaccinated HCWs only) were included in the study. HCWs with unknown test results and unknown vaccination status, were excluded.

Primary and secondary outcome measures
The primary outcome was VE among symptomatic HCWs. Secondary outcomes were VE by: SARS-CoV-2 variant strains based on the predominant variant circulating in Zambia (Delta during May 2021 to November 2021 and Omicron during December 2021 to March 2022), duration since vaccination and vaccine product.

Results
We recruited 1145 symptomatic HCWs. The median age was 30 years (IQR: 26–38) and 789 (68.9%) were women. Two hundred and eighty-two (24.6%) were fully vaccinated. The median time to full vaccination was 102 days (IQR: 56–144). VE against symptomatic SARS-CoV-2 infection was 72.7% (95% CI: 61.9% to 80.7%) for fully vaccinated participants. VE was 79.4% (95% CI: 58.2% to 90.7%) during the Delta period and 37.5% (95% CI: –7.0% to 63.3%) during the Omicron period.

Conclusions
COVID-19 vaccines were effective in reducing symptomatic SARS-CoV-2 among Zambian HCWs when the Delta variant was circulating but not when Omicron was circulating. This could be related to immune evasive characteristics and/or waning immunity. These findings support accelerating COVID-19 booster dosing with bivalent vaccines as part of the vaccination programme to reduce COVID-19 in Zambia.

Studio, la diagnosi precoce possibile con l’analisi sul Pap test

Candidate all’esame 10mila donne con tumore al seno, ma sono in aumento

Trattati con le cellule 15 pazienti italiani

Objective
Symptoms in gastroparesis (Gp) and functional dyspepsia (FD) overlap; using egg protein substitute to measure gastric emptying of solids (GES), ~40% of patients are reclassified from Gp to FD, and vice versa. Our aim was to assess inter-individual and intra-individual coefficients of variation (COV) in GES in symptomatic patients with Gp or FD with documented slow or normal GES, respectively.

Design
Scintigraphic GES (T1/2 and GE% at 2 and 4 hours) using a 320 kcal real egg meal (30% fat) was tested in the following: single measurements in 20 patients with diabetes mellitus (10 each type 1 and type 2); repeat GES to estimate COVintra measured: 3 days apart in 9 Gp, 4 weeks apart in 21 Gp and 18 with FD with normal GE assigned to placebo and in 70 patients at 94.3 weeks (median) apart.

Results
COVinter for GE% at 4 hours and GE T1/2 were respectively 14.2% and 23.5% in FD and 27.5% and 33% in Gp; COVintra for GE% at 4 hours and GE T1/2 up to 4 weeks apart were 23.4% and 37.9% in FD and 20.1% and 33% in Gp. GE% at 2 hours showed less consistent results. However, >85% retained original diagnosis as normal or delayed. From clinical GES to baseline research for Gp group, repeat GES (after treatment) showed the COVintra for GE% at 4 hours was 37.3% at median 94.3 weeks, with 26/70 changed diagnoses.

Conclusion
The 320 kcal (30% fat) GES scintigraphic test provides consistent diagnosis in >85% and should be the standard test for suspected gastric emptying disorders.

Studio italiano,programma fa risultare credibili risultati finti

Objectives
Point-of-care tests (POCTs) for infection offer accurate rapid diagnostics but do not consistently improve antibiotic stewardship (ASP) of suspected ventilator-associated pneumonia. We aimed to measure the effect of a negative PCR-POCT result on intensive care unit (ICU) clinicians’ antibiotic decisions and the additional effects of patient trajectory and cognitive-behavioural factors (clinician intuition, dis/interest in POCT, risk averseness).

Design
Observational cohort simulation study.

Setting
ICU.

Participants
70 ICU consultants/trainees working in UK-based teaching hospitals.

Methods
Clinicians saw four case vignettes describing patients who had completed a course of antibiotics for respiratory infection. Vignettes comprised clinical and biological data (ie, white cell count, C reactive protein), varied to create four trajectories: clinico-biological improvement (the ‘improvement’ case), clinico-biological worsening (‘worsening’), clinical improvement/biological worsening (‘discordant clin better’), clinical worsening/biological improvement (‘discordant clin worse’). Based on this, clinicians made an initial antibiotics decision (stop/continue) and rated confidence (6-point Likert scale). A PCR-based POCT was then offered, which clinicians could accept or decline. All clinicians (including those who declined) were shown the result, which was negative. Clinicians updated their antibiotics decision and confidence.

Measures
Antibiotics decisions and confidence were compared pre-POCT versus post-POCT, per vignette.

Results
A negative POCT result increased the proportion of stop decisions (54% pre-POCT vs 70% post-POCT, 2(1)=25.82, p

This article presents results from a prospective pivotal study in which individuals completed a multitarget stool RNA test prior to undergoing a colonoscopy to determine the sensitivity for detecting colorectal cancer and advanced ademonas.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Circulation, Volume 148, Issue Suppl_1, Page A11613-A11613, November 6, 2023. Background:Adverse hemodynamic responses on exercise stress testing have prognostic impact, but the cumulative effect of multiple abnormalities is not known. These markers include chronotropic incompetence, reduced metabolic equivalents achieved, abnormal hemodynamic gain index, impaired heart rate recovery, and abnormal blood pressure response.Research Questions:In a contemporary population undergoing exercise stress testing, what is the cumulative prevalence and prognostic impact of the number of abnormal stress hemodynamic markers (asHD)?Aims:We measured the prevalence of increasing values of asHD and the associated burden of all-cause mortality and non-fatal myocardial infarction (death/NFMI).Methods:We performed a retrospective, single-center analysis of patients referred for exercise stress myocardial perfusion imaging from 2015-2017. Multivariable Cox proportional hazards modeling was used to explore the relationship between cumulative burden of asHD markers and death/NFMI.Data:The study population included 1,595 patients (mean age 62.1, 36.9% female) with mean follow-up 4.8 years stratified by number of asHD markers (0, 1, 2, or 3+). 60.2% of patients tested had at least one asHD marker. The cumulative burden was 1 asHD in 32%, 2 asHD in 19%, and 3+ asHD in 9.3%. Patients with any asHD were at greater risk for death/NFMI compared to patients with 0 asHD (HR 1.98 [95% CI, 1.39 – 2.83], p