Risultati per: ESC 2022: Linea guida sulla cardio-oncologia

Objectives
In Finland, the reimbursement system for occupational health services (OHSs) was reformed on 1 January 2020 to shift the focus from curative care to preventive OHS and promote employees’ work ability. We investigated the OHS trends and how the reimbursement affected them.

Design
A register-based study that used moving averages to visualise OHS trends in 2018–2022. To detect the impact of the reform, we used two types of interrupted time series (ITS) analyses: a linear regression model (ITS linear model) and an analysis of variance (ANOVA) lagged dependent variable model (ITS ANOVA).

Setting
Retrospective register data (2018–2022) of a major OHS provider in Finland.

Outcome measures
Time spent on OHS activities and the number of OHS activities per 1000 individuals per month. Level and slope changes in these measures in the ITS linear model, as well as the changes in these measures in the ITS ANOVA.

Results
After the reimbursement reform, the trend of preventive OHS shifted from a decline to a rise. Among nurses, the ITS linear model also showed changes of 0.6 hours (95% CI: 0.2 to 0.9) and 0.9 activities (95% CI: 0.2 to 1.7) per 1000 individuals per month. Throughout the study period, the trend of work ability health examinations for both physicians and nurses rose, with a monthly slope change of 0.03 hours (95% CI: 0.01 to 0.04) per 1000 individuals among nurses in the ITS linear model. We observed a descending trend in curative care with a monthly decrease of 14.3 hours (95% CI: –25.5 to –3.1) and 32.4 activities (95% CI: –64.1 to –0.1) per 1000 individuals by all professionals in the ITS ANOVA.

Conclusions
After the 2020 reimbursement reform, the focus of OHS shifted from curative care to preventive OHS. It is likely that the reform affected these changes, although other factors may also have influenced them.

I dati della Relazione 2024 sulla Pma trasmessa al Parlamento

In Italia oltre 100mila con patologie rare non diagnosticate

Circulation, Volume 151, Issue 8, Page 518-520, February 25, 2025.

Primario al Gemelli, autore di molti studi scientifici

Objective
To examine trends in the prevalence of depression and anxiety during the COVID-19 pandemic among US adult cancer patients and survivors (CPS) in comparison to those of non-CPS (NCPS).

Methods and analysis
National Health Interview Survey 2019–2022 data were analysed using spline logistic regression.

Results
A total of 115 664 participants completed the survey (mean age (SD), 52.8 (18.4) years; 54.3% female; 12.6% CPS). The age-adjusted prevalence of depression significantly increased from 26.53% in 2019 to 29.78% in 2022 among CPS, while that of anxiety increased from 24.02% in 2019 to 28.08% in 2022. Throughout the pandemic, there were consistently significant annual increases in the prevalence of both depression and anxiety with CPS experiencing significantly faster rates of increase compared with NCPS (average annual absolute increase 0.72% in NCPS vs 1.08% in CPS, p

Objective
To describe the incidence and key demographic, socioeconomic and clinical characteristics of individuals with liver disease in Wales.

Design and setting
This study is designed as a retrospective observational study that linked data of anonymised identified individuals from primary, secondary care and mortality data from the Secure Anonymised Information Linkage (SAIL) Databank in Wales.

Participants
All Welsh residents who registered with a SAIL-contributing general practitioner (GP) and diagnosed with liver disease from 2004 to 2022.

Primary and secondary outcome measures
Our primary outcome is the annual age-standardised incidence rate of liver disease. Secondary outcome is the numbers and frequencies of underlying aetiology and the associated comorbidities.

Results
Between 2004 and 2022, 111 098 individuals received a diagnosis of liver disease in Wales and were included in this study. The incidence of liver disease increased threefold during the study period (97.7 per 100 000 inhabitants in 2004 to 316.2 per 100 000 inhabitants in 2022). A total of 79 992 individuals (72%) entered the cohort with the underlying aetiology of liver disease, including alcohol-related liver disease, non-alcoholic fatty liver disease (NAFLD), viral hepatitis, metabolic, haemochromatosis and autoimmune liver diseases. NAFLD has contributed to most of the change in incidence.

Conclusions
We observed increasing incidence rates of liver disease in Wales, with NAFLD showing a particularly sharp increase and frequently identified as an underlying condition. A better understanding of the incidence of liver disease is the first step towards effective prevention, early detection and targeted intervention to improve patient outcomes.

Sip, ‘il focus deve spostarsi dal peso alla salute’

Annals of Internal Medicine, Ahead of Print.