Risultati per: Gestione del trauma renale dell’adulto

La disfunzionalità dell’adipe si riflette sui tessuti arteriosi, cardiaci e renali e queste interconnessioni rappresentano una sfida importante per il Ssn, ma anche un’opportunità per migliorare la presa in cura dei pazienti con patologie complesse

Objectives
To develop and validate a simplified Bleeding Audit Triage Trauma (sBATT) score for use by lay persons, or in areas and environments where physiological monitoring equipment may be unavailable or inappropriate.

Design
The sBATT was derived from the original BATT, which included prehospital systolic blood pressure (SBP), heart rate, respiratory rate, Glasgow Coma Scale (GCS), age and trauma mechanism. Variables suitable for lay interpretation without monitoring equipment were included (age, level of consciousness, absence of radial pulse, tachycardia and trapped status). The sBATT was validated using data from the UK Trauma Audit Research Network (TARN) registry.

Setting
Data sourced from prehospital observations from multiple trauma systems in the UK.

Participants
70 027 motor vehicle collision (MVC) patients from the TARN registry (2012–2019). Participants included were those involved in MVCs, with exclusion criteria being incomplete data or non-trauma-related admissions.

Interventions
Not applicable.

Primary and secondary outcome measures
Death within 24 hours of MVC. Secondary: need for trauma intervention.

Results
In a cohort of 70 027 MVC patients, 1976 (3%) died within 24 hours. The sBATT showed an area under receiver operating characteristic curve of 0.90 (95% CI: 0.90 to 0.91) for predicting 24-hour mortality, surpassing other trauma scores such as the Shock Index and Assessment of Blood Consumption score. Sensitivity was 96% and specificity 72%, with a negative likelihood ratio below 0.1, indicating strong rule-out capability. Sensitivity analyses confirmed consistent performance across varying SBP and GCS thresholds. The sBATT was equally effective across sexes with no significant predictive discrepancies.

Conclusions
The sBATT is a novel, simplified tool that performs well at predicting early death in the TARN dataset. It demonstrates high predictive accuracy for 24-hour mortality and need for trauma intervention. Further research should validate sBATT in diverse populations and real-world scenarios to confirm its utility and applicability.

Rinviato a metà gennaio voto su piano revisione Rete oncologica

Domani ad Ancona congresso scientifico alla Politecnica Marche

Stroke, Ahead of Print.

Introduction
The incurable and progressive nature of dementia requires complex care, the majority of which is provided via informal caring by family members within the family home. Carers experience significant stress absorbing the challenging care needs of their family member and require education and training that can support and sustain family caring arrangements while considering the psychological distress that threatens caring breakdown. The aim of this scoping review was to map the evidence of trauma-informed principles within education and practical skills training in dementia family caring.

Methods and analysis
A two-step approach to the selection of literature will be used. In step 1, the review will consider research on active intervention education and practical skills training to support family home-based informal care for individuals with a formal diagnosis of dementia. The review will exclude passive education and self-accessed information/training provision. Only literature in the context of ‘informal’ day-to-day family caring provided by a family member or friend that takes place in the family home or residence will be included. Education and practical skills training provision within specialist care environments will be excluded. In step 2, during the full-text screen, only research where either explicit or implicit use of trauma-informed approaches has been used will be included.
Preliminary searches of MEDLINE Ovid and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were carried out between March and May 2023 to identify literature in this area. In line with the Johanna Briggs Institute scoping review guidance, we will conduct a search of published literature within MEDLINE Ovid, Embase Ovid, CINAHL EBSCO, Cochrane Data for Systematic Reviews and Cochrane Central Register for Controlled Trials in the Cochrane Library, PsycINFO Ovid and the British Library EThOS e-theses online. Publications in English with a date range of 1990 to current, with no restriction on geographical region will be considered. The search will be managed by Rayyan software and screened by multiple independent researchers. Results will be presented using narrative summaries and tables.
We collaborated with an experienced Academic Support Librarian to develop the MEDLINE Ovid search strategy (Appendix 1), which will be adapted for searching other databases.

Ethics and dissemination
Ethical approval was not required for this review, as it involved the synthesis of publicly available secondary data. The findings will be disseminated through publication in peer-reviewed journals, as well as presentations at national and international conferences. Additionally, stakeholder events will engage carers, individuals with lived experience, and healthcare professionals.

Araldi, ‘con MedMal Report identifichiamo aree più a rischio’