Risultati per: Nuovo test rapido per distinguere le infezioni virali

Basato sull’intelligenza artificiale, ha il 91% di accuratezza

il ministero della Salute ha deciso di intervenire con una circolare per regolare la questione dei test per chi entra in ospedale: pazienti o visitatori

Autism spectrum disorder (hereafter, “autism”) affects the ability to socially interact and communicate with others and is diagnosed in 1 in 36 children in the United States. The early course and clinical presentation of autism are variable, and differential diagnosis of young children can be challenging even for autism specialists. For example, one study found that only 60% of autism diagnoses were made with certainty in a sample of 478 toddlers and preschoolers who had been referred to specialists for an autism evaluation. In a 6-site study where diagnostic evaluations were conducted by experienced clinicians with 496 children aged 16 to 30 months referred to specialized centers, only 70.2% of diagnoses were made with a high level of certainty. Thus, approximately 1 in 3 autism diagnostic evaluations of young children are associated with uncertainty. Children with higher cognitive and language abilities and milder autism-related behaviors are more likely to be missed and often receive their diagnoses later than those with greater language delays and more pronounced autism-related behaviors. The high degree of diagnostic uncertainty for young autistic children contributes to delays in access to supports and services. Receiving an autism diagnosis is a first step to qualifying for early behavioral therapies that have been shown to improve outcomes, including language, cognitive, social, and adaptive skills.

Colpiti i giovani, spesso senza diagnosi. Oggi la giornata mondiale

Colpiti i giovani, spesso senza diagnosi. Il 4 settembre giornata mondiale

In this issue of JAMA Psychiatry, Marcotte et al report that field sobriety tests (FSTs) as administered by highly trained police officers are insufficient to detect cannabis-induced impairment in a double-blind, placebo-controlled, parallel randomized clinical trial involving a large sample of 184 cannabis users. Although the group receiving active doses of Δ-9-tetrahydrocannabinol (THC), the active ingredient in cannabis, performed worse on the FSTs as compared with the placebo group; about half of the participants in the placebo group were classified as impaired. These findings are in line with previous placebo-controlled studies that also reported high false-positive FST rates under placebo. The legal implication of these findings can be major given that FSTs are currently part of the evaluation protocol in North America to detect drivers who are cannabis impaired. Yet, the lack of sensitivity of FSTs to detect THC-impaired individuals does not come as a big surprise, as FSTs have primarily been validated to detect gross alcohol impairment at high (more than 0.10%) blood alcohol concentrations. To add to this problem, there is no cannabis equivalent of a breathalyzer to verify exposure induced impairment, as trace amounts of THC in biomarkers correlate poorly with cannabis-induced behavioral impairment.

Low-grade dysplasia (LGD) is associated with an increased risk of progression in Barrett’s esophagus (BE). However, the diagnosis of LGD is limited by substantial interobserver variability. Multiple studies have shown that an objective tissue systems pathology test (TissueCypher Barrett’s Esophagus Assay, TSP-9), can effectively predict neoplastic progression in patients with BE. This study aimed to compare the risk stratification performance of the TSP-9 test versus benchmarks of generalist and expert pathology.

Prorogati inoltre anche gli scorrimenti della graduatoria del precedente concorso MMG, valida per il Triennio 2022-25

Studio pubblicato su Frontiers in Immunology

Objectives
To perform a budget impact analysis of the HepClink test-and-treat strategy in which community health agents offer hepatitis C virus (HCV) testing, diagnosis and treatment to the Pakistani population living in Catalonia compared with the current practice of the Catalan health system (without targeted screening programmes).

Methods
We estimated the population of adult Pakistani migrants registered at the primary care centres in Catalonia by means of the Information System for the Development of Research in Primary Care (n=37 972 in 2019, Barcelona health area). This cohort was followed for a time period of 10 years after HCV diagnosis (2019–2028). The statistical significance of the differences observed in the anti-HCV positivity rate between screened and non-screened was confirmed (α=0.05). The budget impact was calculated from the perspective of the Catalan Department of Health. Sensitivity analyses included different levels of participation in HepClink: pessimistic, optimistic and maximum.

Results
The HepClink scenario screened a higher percentage of individuals (69.8%) compared with the current scenario of HCV care (39.7%). Viraemia was lower in the HepClink scenario compared with the current scenario (1.7% vs 2.5%, respectively). The budget impact of the HepClink scenario was 884 244.42 in 10 years.

Conclusions
Scaling up the HepClink strategy to the whole Catalan territory infers a high budget impact for the Department of Health and allows increasing the detection of viraemia (+17.8%) among Pakistani migrants ≥18 years. To achieve a sustainable elimination of HCV by improving screening and treatment rates, there is room for improvement at two levels. First, taking advantage of the fact that 68.08% of the Pakistani population had visited their primary care physicians to reinforce targeted screening in primary care. Second, to use HepClink at the community level to reach individuals with reluctance to use healthcare services.

New England Journal of Medicine, Ahead of Print.

Objectives
This pilot study assessed whether a peer-supported, WhatsApp-assisted lifestyle modification intervention for weight reduction is feasible to execute a definitive trial.

Design
A mixed-methods, single group, pretest and post-test, quasi-experimental study.

Setting
Azam Basti, an urban slum in Karachi, Pakistan.

Participants
Fifty participants (males and females aged 20–60) with a body mass index of >23 kg/m2, along with their nominated peers from the same family.

Intervention
Using motivational interviewing techniques, a trained nutritionist delivered the lifestyle modification intervention to the participants and peers for 3 days after the baseline assessment and then once monthly for 1 year. The intervention was delivered in groups using WhatsApp voice calls. The education sessions mainly focused on dietary modifications, physical activity advice and peer-support assignments to achieve a 5% wt loss from the participant’s initial body weight.

Outcomes
The feasibility measures included screening, recruitment, retention and monthly interview response rates. At 1 year, in-depth interviews (IDIs) with participants and peers were conducted to explore the facilitators, barriers, acceptability and experiences of the intervention. Changes in weight, calorie intake/day and calorie expenditure/day were also assessed.

Results
The recruitment and retention rates were 32% (n=50/156) and 78% (n=39/50), respectively, while the response rate for monthly interviews ranged between 66% (n=33) and 94% (n=47). The mean weight loss at 1 year was 2.2 kg, and the reduction in mean calorie intake was 386 kcal/day. There were no changes in the mean calorie expenditure. During the IDIs, participants and peers reported intervention via WhatsApp and peer support as convenient, flexible and supportive.

Conclusions
The quantitative and qualitative findings of the current pilot study support the scale-up of this work with minor modifications to the screening method as well as close monitoring and motivational interviewing to improve adherence in terms of physical activity.

Trial registration number
NCT05928338.

To the Editor The systematic review and meta-analysis conducted by Roddy Mitchell et al provides new evidence on the epidemiology of perinatal depression (PD) in low- and middle-income countries. The pooled prevalence of PD in this study was 24.7%. However, rates were higher in studies that used self-report screening tools (25.3%) compared with diagnostic interviews (17.8%). More than 90% of the studies used a self-report screening instrument, predominantly the Edinburgh Postnatal Depression Scale (EPDS), but none of them adjusted apparent prevalence estimates (the ones derived by applying thresholds of screening instruments) to true prevalence estimates (the ones incorporating uncertainty of the screening instruments). We have reanalyzed the results of this study by applying bayesian adjustment to correct apparent to true prevalence estimates.