Risultati per: Standard Italiani per la cura del diabete mellito

Newsweek, struttura romana è 35/ma su 250. Altri 13 in classifica

Ne soffrono 9 milioni di italiani. Solo 777mila sono in trattamento

Attivo da anni, il percorso culturale, organizzativo e istituzionale ha fatto registrare risultati positivi sia dal punto di vista terapeutico sia sulla spesa sanitaria

L’internista, “rivedere il concetto in un’ottica di riabilitazione”

We read with high interest the randomised controlled trial (RCT) of Chan et al investigating over-the-scope clips (OTSC) versus standard therapy for the prevention of rebleeding in large (≥1.5 cm) peptic ulcers.1 However, this study and some aspects of study design deserve further critical evaluation and interpretation. One hundred patients with peptic ulcer bleeding and lesion size ≥1.5 cm were randomised to OTSC or standard treatment. In the intention-to-treat analysis, the primary endpoint of clinical rebleeding within 30 days was achieved in 10% with OTSC vs 18% with standard therapy. The difference was statistically not significant. Two previously published RCTs assessing OTSC first-line therapy in non-variceal upper gastrointestinal (GI) bleeding have shown superiority to standard treatment.2 3 In both trials, only high-risk patients were included (eg, patients with haemodynamic instability or Rockall Score ≥7). The only selection criterium in the study of Chan et al…

Restare fisicamente attive, dieta con fibre, frutta e verdura

A poco meno di un anno dalla fine della pandemia è questo uno dei lasciti dell’esperienza del Covid

Consulti gratuiti dai nutrizionisti della Fondazione Longo

Grazie a nuove terapie la sopravvivenza è notevolmente migliorata

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Stroke, Ahead of Print. BACKGROUND:Timely intravenous thrombolysis and endovascular thrombectomy are the standard reperfusion treatments for large vessel occlusion stroke. Currently, it is unknown whether a low-dose thrombolytic agent (0.6 mg/kg alteplase) can offer similar efficacy to the standard dose (0.9 mg/kg alteplase).METHODS:We enrolled consecutive patients in the multicenter Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke who had received combined thrombolysis (within 4.5 hours of onset) and thrombectomy treatment from January 2019 to April 2023. The choice of low- or standard-dose alteplase was based on the physician’s discretion. The outcomes included successful reperfusion (modified Thrombolysis in Cerebral Infarction score, 2b–3), symptomatic intracerebral hemorrhage, 90-day modified Rankin Scale score, and 90-day mortality. The outcomes between the 2 groups were compared using multivariable logistic regression and inverse probability of treatment weighting-adjusted analysis.RESULTS:Among the 2242 patients in the Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke, 734 (33%) received intravenous alteplase. Patients in the low-dose group (n=360) were older, had more women, more atrial fibrillation, and longer onset-to-needle time compared with the standard-dose group (n=374). In comparison to low-dose alteplase, standard-dose alteplase was associated with a lower rate of successful reperfusion (81% versus 87%; adjusted odds ratio, 0.63 [95% CI, 0.40–0.98]), a numerically higher incidence of symptomatic intracerebral hemorrhage (6.7% versus 3.9%; adjusted odds ratio, 1.81 [95% CI, 0.88–3.69]), but better 90-day modified Rankin Scale score (functional independence [modified Rankin Scale score, 0–2], 47% versus 31%; adjusted odds ratio, 1.91 [95% CI, 1.28–2.86]), and a numerically lower mortality rate (9% versus 15%; adjusted odds ratio, 0.73 [95% CI, 0.43–1.25]) after adjusting for covariates. Similar results were observed in the inverse probability of treatment weighting-adjusted models. The results were consistent across predefined subgroups and age strata.CONCLUSIONS:Despite the lower rate of successful reperfusion and higher risk of symptomatic intracerebral hemorrhage with standard-dose alteplase, standard-dose alteplase was associated with a better functional outcome in patients receiving combined thrombolysis and thrombectomy.

Un nuovo studio dell’Università Tor Vergata ne dimostra il ruolo benefico

Nuovo studio Università Tor Vergata ne dimostra ruolo benefico