Risultati per: Come si esegue la raccolta delle urine delle 24 ore

Stroke, Volume 56, Issue Suppl_1, Page ATP21-ATP21, February 1, 2025. Introduction：The efficacy of blood pressure (BP) reduction of Sacubitril/valsartan has been proved in hypertension patients, yet not in patients with acute ischemic stroke (AIS). We aimed to investigate the efficacy and safety of Sacubitril/Valsartan in AIS patients with hypertension within 24-72 hours of symptom onset.Methods：Between November 2022 and May 2024, patients with AIS within 24-72h of symptom onset and BP≥140/90 mmHg were enrolled and randomly assigned to receive Sacubitril/Valsartan (100-200mg qd) or other antihypertensive medications determined by clinical physicians as the ratio of 1:1. Randomized antihypertensive treatment strategy was required to complied for 14 days, and allowed to be changed after day 14 if the BP control was not satisfied. All enrolled patients received other early medical managements based on the AIS guideline. The primary outcome was the proportion of participants who had a modified Rankin scale(mRS) score of 0-1 at 90 days. The secondary outcome was the rate of target BP control (mean BP

A eseguirli con successo l’equipe del professor Tomaso Bottio

Delicato intervento all’ospedale Cardarelli di Campobasso

Background
Children in paediatric emergency units are those who need special attention, and unless treated early, they are a vulnerable population to unwanted outcomes like death, discharge against medical advice or referral to other institutions within 24 hours.

Objectives
To assess admission outcomes and their associated factors among children admitted to the paediatric emergency unit of Dilla University Referral Hospital, Ethiopia, 2023.

Methods
An institution-based cross-sectional study design was employed among children admitted to the paediatric emergency unit at Dilla University Referral Hospital from 8 May 2023 to 8 June 2023. A total of 885 complete charts of the children aged 29 days to 14 years were analysed. Structured checklist was used for data collection. STATA V.14 was used for data analysis. A multinomial logistic regression model was used to determine the factors associated with admission outcomes. Overall model fitness was checked using the likelihood ratio test.

Result
Out of 885 patient charts reviewed, the magnitude of patients improved, transferred, died, referred and discharged against medical advice was 51%, 40.9%, 7.6%, 0.1% and 0.4%, respectively. Children presented with diarrhoea (adjusted OR (AOR) =2.92, 95% CI 1.46 to 5.84), severe respiratory distress (AOR=5.08, 95% CI 2.49 to 10.35), coma (AOR=3.71, 95% CI 1.24 to 11.13), comorbidity (AOR=3.33, 95% CI 1.49 to 7.41) and delay to seek healthcare (AOR=1.99, 95% CI 1.03 to 3.83) were significantly associated factors with emergency unit mortality, whereas pneumonia (AOR=1.76, 95% CI 1.16 to 2.65) and severe acute malnutrition (AOR=3.46, 95% CI 2.06 to 5.81) were significantly associated factors with intrahospital unit/ward transfer.

Conclusion
The magnitude of mortality, transfer to the ward and discharge against medical advice were relatively higher. Interventions focused on early diagnoses, and the initiation of appropriate treatments was of the utmost relevance to improving patient outcomes.

Musso, ‘grazie ai donatori. Passo verso autosufficienza Italia’

Introduction
Stress hyperglycaemia at hospital presentation is associated with poorer outcomes. Less is known about the risk of poorer outcomes according to achieved glycaemia early in the admission.

Research design/methods
This was a retrospective observational study of patients admitted to non-critical care wards. The aim was to determine the relationship between the day 2 peak blood glucose and the occurrence of hospital-acquired complications (HACs) or in-hospital mortality. A Cox proportional hazards model, adjusted for relevant covariates, was used to evaluate the impact of day 2 peak glucose on HACs and in-hospital mortality, and we identified peak glucose thresholds correlating with an increase in risk.

Results
For the whole cohort, day 2 peak glucose was associated with an increased risk of any HAC, aHR=1.06, 95% CI: 1.04, 1.07; but not in-hospital mortality, aHR=0.98, 95% CI: 0.94, 1.01. The risk of HAC infection increased by 4.6% for every mmol/L rise in day 2 peak glucose (aHR=1.05, 95% CI: 1.02, 1.08) in the diabetes cohort compared with 5.5% (aHR=1.06, 95% CI: 1.00, 1.11) in the non-diabetes cohort. The risk of HAC cardiac in the diabetes cohort increased by 5.3% (aHR=1.05, CI: 1.01, 1.10) per mmol/L increase in day 2 peak glucose; no association was found in the non-diabetes cohort (aHR=1.03, 95% CI: 0.94, 1.13). The risk for in-hospital mortality was associated with day 2 peak glucose, aHR=1.11, 95% CI: 1.03, 1.20, in patients without diabetes, but not in patients with diabetes, aHR=1.00, 95% CI: 0.95, 1.06. There was an increase in the risk of HAC once day 2 peak blood glucose exceeded 19.0 mmol/L (whole cohort), with thresholds of 13.6 mmol/L in the non-diabetes group and 19.5 mmol/L in the diabetes group.

Conclusion
The peak glucose on day 2 was a predictor of HAC in the entire cohort and in-hospital mortality in patients without diabetes.

In attesa di un posto letto in un ospedale del Salernitano

Objective
To evaluate the impact of Nurse-Family Partnership (NFP), a home-visiting programme, on exploratory maternal outcomes in British Columbia (BC), Canada.

Design
Pragmatic, parallel arm, randomised controlled trial conducted October 2013–November 2019. Random allocation of participants (1:1) to comparison (existing services) or NFP (plus existing services). Researchers were naïve to allocation.

Setting
26 local health areas across four of five BC regional health authorities.

Participants
739 young (

Analisi potrebbe individuare primissimi segni cellule cancerose

Stroke, Ahead of Print. BACKGROUND:Whether it is effective and safe to extend the time window of intravenous thrombolysis up to 24 hours after the last known well is unknown. We aimed to determine the efficacy and safety of tenecteplase in Chinese patients with acute ischemic stroke due to large/medium vessel occlusion within an extended time window.METHODS:Patients with ischemic stroke presenting 4.5 to 24 hours from the last known well, with a favorable penumbral profile and an associated large/medium vessel occlusion, were randomized 1:1 to either 0.25 mg/kg tenecteplase or the best medical treatment. A favorable penumbral profile was defined as a hypoperfusion lesion volume to infarct core volume ratio >1.2, with an absolute volume difference >10 mL, and an ischemic core volume 50% of the involved ischemic territory. Secondary outcomes included recanalization, infarct growth, major neurological improvements, change in the National Institutes of Health Stroke Scale score, hemorrhagic transformation within 24 to 48 hours, systemic bleeding at discharge, and modified Rankin Scale (score 0–1, score 0–2, score 5–6, and modified Rankin Scale distribution) at 90 days. The comparison of the primary outcome between groups was conducted using modified Poisson regression with a log-link function and robust error variance, adjusted for time from the last known well to randomization, the site of vessel occlusion, and planned endovascular treatment.RESULTS:Among 224 enrolled patients, 111 were assigned to receive tenecteplase and 113 to receive the best medical treatment (including 23% [n=26] of participants who received intravenous tissue-type plasminogen activator). The mean (SD) age of the tenecteplase group and the best medical treatment group was 64.2 (10.4) and 63.6 (11.0) years old, with 72.1% (n=80) and 70.8% (n=80) male enrolled, respectively. A proportion of 54.9% (n=123) of patients were transferred to the catheter room for preplanned endovascular treatment. The primary outcome occurred in 33.3% (n=37) of the tenecteplase group versus 10.8% (n=12) in the best medical treatment group (adjusted relative risk, 3.0 [95% CI, 1.6–5.7];P=0.001). Tenecteplase significantly increased the recanalization rate compared with the best medical treatment (35.8% [n=39] versus 14.3% [n=16], adjusted relative risk, 2.5 [95% CI, 1.4–4.4];P=0.002). There were no significant differences in clinical efficacy outcomes or rates of hemorrhagic transformation between the groups.CONCLUSIONS:Administered at a dose of 0.25 mg/kg intravenously, tenecteplase increased reperfusion without symptomatic intracranial hemorrhage in patients with ischemic stroke selected by imaging in late-time window treatment but did not change clinical outcomes at 90 days.REGISTRATION:URL:https://www.clinicaltrials.gov; Unique identifier: NCT04516993.

Studio, performance ancora migliori se si dorme bene

All’Ortopedia traumatologica dell’ospedale Garibaldi di Catania

New England Journal of Medicine, Volume 391, Issue 22, Page 2175-2176, December 5, 2024.

Sono stati realizzati 4 di rene, 2 di fegato ed uno di polmoni