Il progetto SENSE (esperienza Sensoriale nella gestione e trattamento del Neurofibroma pleSsiformE), realizzato grazie al contributo non condizionante di Alexion, nasce dalla volontà di proporre un approccio più profondo, umano e multidisciplinare a una delle sfide più delicate nell’ambito delle malattie rare pediatriche: accompagnare i bambini con neurofibromatosi di tipo 1 (NF1) nella complessa gestione del neurofibroma plessiforme (PN).
Search Results for: FIGO: linee guida sulla gestione dell’emorragia postpartum
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Vasculiti ANCA-associate, conferme per avacopan da studi di real life #EULAR2025 [Ortopedia e Reumatologia]
Nel corso del congresso EULAR, sono stati presentati nuovi dati che suffragano l’impiego di avacopan nel trattamento di due vasculiti ANCA-associate (la granulomatosi con poliangioite e la poliangioite microscopica – GPA ed MPA). Il primo (AVAC-EUR), uno studio osservazionale multicentrico retrospettivo europeo, ha mostrato come la continuazione del trattamento con il farmaco si accompagni ad una riduzione delle ospedalizzazioni e dei tassi di infezione rispetto al quanto osservato con l’ìnterruzione del trattamento entro un anno. Il secondo, uno studio prospettico multicentrico italiano di real life, ha dimostrato l’efficacia precoce e duratura, la sicurezza e i miglioramenti nei punteggi della qualità di vita associati al trattamento con avacopan nella gestione delle vasculiti sopra indicate. in una coorte di pazienti italiani.
I rischi da latte crudo aumentano in estate, nuove Linee Guida
Documento per ridurre contagi da batteri pericolosi nei fragili
Presentato in Senato il Position Paper sui PDTA per amiloidosi da transtiretina [Cardio]
Un paziente con amiloidosi cardiaca da transtiretina (ATTR) oggi in Italia può ricevere diagnosi e cure molto diverse a seconda della Regione in cui vive. Eppure, questa malattia rara, spesso sottovalutata e diagnosticata troppo tardi, necessita di un percorso di cura rapido, personalizzato e multidisciplinare.
Per rispondere a questa sfida, Bistoncini Partners ha realizzato, con il contributo non condizionante di Pfizer, il Position Paper: “L’importanza dei PDTA personalizzati per la gestione del paziente con Amiloidosi da Transtiretina”, che viene oggi presentato nel corso di una conferenza stampa promossa dalla Senatrice Elena Murelli
Eczema cronico delle mani, perché è necessario parlare di epidemiologia? [Dermatologia]
L’eczema cronico delle mani rappresenta una sfida significativa sia clinica che sociale, e la sua gestione non può prescindere da una solida conoscenza epidemiologica. Affrontare l’argomento dal punto di vista epidemiologico è fondamentale per molteplici ragioni, che vanno ben oltre la semplice descrizione clinica. E’ stato questo il tema della relazione della Dott.ssa Emanuela Martina, Specialista in Dermatologia e Venereologia, SOD Clinica di Dermatologia, AOU delle Marche, Ancona, in occasione della Special Edition del congresso SIDeMaST-ADOI che si è svolto in parallelo alla prima giornata del XIV International Congress of Dermatology.
Gestione dell'infezione da HIV: importanza dell'ottimizzazione della terapia [Infettivologia]
La gestione dell’infezione da HIV ha fatto enormi progressi, portando oggi la maggior parte delle persone con HIV in trattamento a raggiungere e mantenere una viremia non rilevabile. Tuttavia, l’efficacia della terapia antiretrovirale (ART) non è più il solo parametro da considerare: l’ottimizzazione della terapia è diventata fondamentale per garantire che il trattamento sia ben tollerato, sostenibile e adattato alle esigenze individuali, migliorando così l’aderenza e la qualità di vita del soggetto, in una prospettiva di successo a lungo termine.
Randomised controlled trial comparing low doses of aspirin in the prevention of pre-eclampsia (ASAPP): a study protocol
Introduction
Pre-eclampsia (PEC) is a morbid and potentially lethal complication of pregnancy and is more common in women with risk factors such as hypertension, diabetes, autoimmune disease, kidney disease or multifetal pregnancies. Low dose aspirin (ASA) is currently the only prophylactic therapy known to decrease PEC in this patient population. However, currently, there is no prospective literature comparing various low-dose ASA formulations in the risk reduction of PEC. In the USA, the currently available low-dose ASA is over-the-counter and found in 81 mg tablets. Therefore, when clinicians initiate low-dose ASA therapy, they may prescribe one or two tablets of 81 mg per day without comparative evidence to guide their decision. Our objective is to prospectively compare pregnant patients on 81 mg vs 162 mg of ASA and determine a possible dose response in the prevention of PEC.
Methods and analysis
We designed a pragmatic phase 3 prospective randomised open label blinded-end point clinical trial with parallel assignment between two groups of pregnant people at high risk for PEC, as defined by the US Preventive Services Task Force and American College of Obstetricians and Gynecologists (ACOG). The primary outcome is the incidence of preterm (
Tumore della prostata: presentata la campagna 'Allo Specchio della Salute' [Oncologia-Ematologia]
In Italia, il carcinoma della prostata rappresenta la neoplasia più diffusa tra gli uomini over 50, incidendo per circa il 30% su tutti i tumori maschili, con 40.192 nuovi casi stimati solo nel 2024. È stata presentata oggi, in Senato la campagna di sensibilizzazione ‘Allo Specchio della Salute – uno spazio di confronto sul carcinoma prostatico’, pensata per coinvolgere l’intera comunità nel dibattito intorno alla gestione e cura di questa patologia. Un’intera giornata dedicata al carcinoma della prostata suddivisa in due appuntamenti sinergici e xomplementari: la conferenza stampa seguita dalla campagna di awareness.
Bambino Gesù firma accordo di 20 anni per gestione Casa Ronald
A Palidoro, struttura continuerà a offrire accoglienza famiglie
Psychological birth trauma and its related factors, and providing strategies for prevention of psychological birth trauma: protocol for an explanatory sequential mixed-method study
Background
Childbirth can have psychological, social and emotional effects on women and their families. Psychological birth trauma (PBT) is defined as the emotional distress and mental health challenges resulting from negative or distressing experiences during the childbirth process. Labour management plays an important role in the health of women and children. Consequently, the study aims to assess the status of PBT among Iranian women, identify factors influencing it and suggest effective preventive strategies.
Methods and analysis
This study is a mixed-method research with an explanatory sequential approach. The first phase is quantitative and cross-sectional, involving 300 postpartum women visiting health centres in Tabriz-Iran. In this phase, cluster sampling will be used, and data will be collected using the following questionnaires: Sociodemographic and Obstetric Characteristics, Birth Trauma Scale, PTSD Symptom Scale 1, Perceived Quality of Care Scale, Childbirth Experience Questionnaire version 2.0, Edinburgh Postpartum Depression Scale, Postpartum Specific Anxiety Scale Research Short-Form and the questionnaire on the desire for subsequent pregnancy. The second phase is qualitative, and participants will be selected based on the results of the quantitative phase and extreme cases, using purposive sampling. Data analysis will be performed using qualitative content analysis with a conventional approach. Qualitative data will be collected through in-depth and semi-structured individual interviews with open-ended questions. In the third phase, strategies to prevent childbirth psychological trauma will be designed by integrating the results of the quantitative and qualitative studies, reviewing the literature and gathering expert opinions using a modified Delphi study. Examining PBT and its influencing factors can provide culturally relevant, evidence-based strategies. These strategies can be effective in improving the quality of care for women during childbirth.
Ethics and dissemination
This study has received approval from the Ethics Committee of Tabriz University of Medical Sciences in Tabriz, Iran (code number: IR.TBZMED.REC.1402.945). All participants will provide written informed consent before taking part in the study. The outcomes will be shared through articles published in journals, presentations at medical conferences, the validation of a reliable scale for assessing the level of PBT in postpartum women, and the provision of strategies to prevent childbirth psychological trauma. These resources will be valuable for policymakers and healthcare providers.
Linea guida sulla gestione della malattia venosa cronica
La Society for Cardiovascular Angiography and Interventions (SCAI) ha pubblicato una linea guida sulla […]
Iss, 'allerta caldo anche a tavola, attenzione a conservazione'
La guida dell’Istituto sui cibi e le regole da rispettare
Effectiveness of Kushal Maa, a group-based mhealth interactive education and social support intervention for maternal and neonatal health outcomes: study protocol for a multisite randomised controlled trial in India
Introduction
Perinatal care continuity across the full continuum is essential for optimising maternal and infant health; however, a stark gap occurs post partum, with less than one half of Indian mothers receiving postpartum care due to significant logistical and sociocultural barriers, particularly for periurban and rural residents. To overcome these barriers and reduce women’s postpartum isolation, our international team of maternal and infant health clinicians and researchers developed and pilot-tested a culturally-tailored mobile interactive education and support group intervention, Kushal Maa (‘informed-mother’), confirming feasibility and acceptability and preliminary effectiveness. The current study seeks to estimate the effectiveness of the Kushal Maa intervention compared with standard care on maternal and neonatal health-related behaviours and health, characterise the mechanisms of intervention impact and evaluate the cost-effectiveness of the Kushal Maa intervention in improving postpartum maternal and neonatal health compared with the standard of care.
Methods and analysis
We will conduct a prospective, parallel block-randomised controlled trial with a 1:1 allocation ratio among 2100 pregnant women across three geographically diverse Indian states. Inclusion criteria for women: aged 18+years of age at enrolment, in the last trimester of pregnancy (30–33 weeks of gestation), with any parity, carrying single or multiple gestation (1-2), with knowledge of site-specific local language and had access to a mobile phone. Participants will be block-randomised in groups of 15. Intervention participants will receive 28 tailored education and support sessions weekly via audio/video conference facilitated by trained moderators (four prenatal and 24 weekly postpartum sessions through 6 months) and will be engaged in WhatsApp groups for health education videos and peer discussion via text chat. Control participants receive the standard of care. Data will be collected at four points: 30–33 weeks of pregnancy (enrolment), 6 weeks, 3 months and 6 months postpartum (endline). Investigators, outcome assessors and data analysts will be blinded to group allocation. Primary outcomes will be measured at 6 weeks, 3 months and 6 months post partum and include: postpartum depression (using Edinburgh Postnatal Depression Scale), exclusive breastfeeding and met need for postpartum family planning. Secondary outcomes include other maternal and child health knowledge, outcomes and maternal and newborn healthcare use indicators. We will use intention-to-treat analysis. Mixed-effects models will account for clustering due to the group-oriented delivery of the intervention and repeated measures.
Ethics and dissemination
This study has been approved by the Health Ministry Screening Committee, Government of India and approved by ethics boards at the Post-Graduate Institute for Medical Education and Research, Chandigarh (Ref:001208, IEC-06/2022–2471), Maharashtra University of Health Sciences (Ref: MUHS/EC/06/2024), Sangath (Ref: AB_2022_81) and the University of California, San Francisco (Ref: 21–35730). All research activities will be performed in accordance with the Declaration of Helsinki. On completion, findings will be disseminated to stakeholders through diverse strategies. Results will be published in academic journals and presented at conferences.
Trial registration number
ClinicalTrials.gov: NCT05268588 Clinical Trials Registry – India: CTRI/2022/07/043889.
Using qualitative research and the person-based approach to coproduce an inclusive intervention for postpartum blood pressure self-management
Objective
To coproduce an inclusive intervention for blood pressure (BP) self-management post partum.
Design
Using the person-based approach, an intervention was coproduced in three phases. Phase 1 entailed intervention coproduction with a diverse patient and public involvement panel and stakeholders (clinical, academic, government and third sector-based). Phase 2 involved intervention optimisation through think-aloud interviews with former patients and clinicians. Phase 3 was user-testing followed by semistructured interviews with current patients and their clinicians.
Setting
Patients and clinicians from primary and secondary care drawn from Southern and Northern England.
Participants
Seven former patients and 11 clinicians participated in think-aloud interviews to provide their views of intervention prototypes (phase 2). Additionally, 23 patients and 9 of their clinicians participated in semistructured interviews after using the intervention for 2 weeks (phase 3).
Intervention
An interactive patient app—My BP Care—and accompanying leaflet to support BP self-monitoring. These were linked to a clinician dashboard with alerts and an emailing system to facilitate appropriate titration of patient medication.
Results
The intervention was codeveloped following these guiding principles to ensure it was accessible and inclusive: easily comprehensible, motivating, simple and quick to use. Interview findings indicated that patient adherence to the intervention was promoted by the initial patient training conducted by the midwives, the enhanced clinical oversight they felt they received as a result of the intervention, the free BP monitor they received, reassurance they received of the medication safety for them and their baby, the intervention’s simplicity and the motivating reminders they received.
Conclusions
Through coproduction with a diverse group of patients and stakeholders, and optimisation through testing among further diverse patients and clinicians, we developed a multicomponent intervention that is accessible and engaging for diverse patients, compatible with prevailing clinical practice and adaptable to different clinical contexts.
Come affrontare la gestione dell’obesità nello scompenso cardiaco
Una nuova Dichiarazione Scientifica dell’American College Cardiology affronta la gestione dell’obesità negli […]
Le linee guida per migliorare le cure e la qualità di vita dei pazienti
39 quelle firmate dagli oncologi Aiom. Il caso delle terapie neoadiuvanti