Risultati per: La fragilità: il maggior fattore prognostico indipendente di COVID‑19 nel set delle Cure Primarie

Rapporto 2023,sospetto legame solo per 1 caso shock anafilattico

39 quelle firmate dagli oncologi Aiom. Il caso delle terapie neoadiuvanti

Objective
To analyse the uptake rate of Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT)-recommended core outcome set (COS) in randomised controlled trials (RCTs) on chronic neck or shoulder pain and its potential influencing factors.

Design
A cross-sectional study.

Setting
WHO International Clinical Trials Registry Platform, involving 15 registries.

Participants
RCT registrations on chronic neck or shoulder pain.

Primary outcome measures
The uptake rate of IMMPACT-recommended COS in RCTs focusing on chronic neck or shoulder pain.

Results
A total of 1057 RCT registrations were included between 2 February 2004 and 8 February 2023. The most used domains were pain (n=1003, 94.9%) and physical functioning (n=971, 91.9%), while the remaining four core domains and supplementary domains received less attention (

New England Journal of Medicine, Ahead of Print.

3/o anno Fondazione Onda, servizi gratuiti clinico-diagnostici

3/o anno Fondazione Onda, servizi gratuiti clinico-diagnostici

3/o anno Fondazione Onda, servizi gratuiti clinico-diagnostici

Objectives
This study aimed to examine the impact of the first COVID-19 lockdown period on access to postnatal contraception (PNC) and wider postnatal care and to explore the experiences of PNC care within the North East and North Cumbria (NENC) Integrated Care System (ICS) during the same period.

Design
This study reports a subanalysis of the NENC Postnatal Contraception (PoCo) study, an online survey of a convenience sample of women in the NENC ICS who completed pregnancies between 2019 and 2023.

Setting
Women who completed pregnancies between 2019 and 2023 in the NENC ICS.

Participants
Out of the total 2509 eligible participants who completed the PoCo survey, women who delivered in April–June 2020, April–June 2021 and April–June 2022 were included within this subanalysis, resulting in 457 eligible survey responses. There were no additional exclusion criteria.

Primary and secondary outcome measures
Primary outcome measures were PNC uptake and number of healthcare professional contacts during the postnatal period. Secondary outcome measures were self-reported experiences of PNC care.

Results
Women who delivered in April–June 2020 had fewer postnatal contacts than women who delivered in subsequent non-lockdown cohorts and were less likely to be offered PNC prior to discharge. There were no significant differences in relation to PNC uptake. In qualitative analyses, several women who delivered in 2020 highlighted COVID-19 as a factor perceived to be associated with poor postnatal care. Across all three groups, experiences of PNC care were diverse; feeling pressured to accept PNC was frequently reported.

Conclusions
While the first COVID-19 lockdown appears to have had a significant impact on women’s experiences of postnatal care, this did not result in a substantive decrease in PNC provision, likely reflecting pre-existing shortcomings. These women and families may benefit from additional support postpandemic to mitigate the potential life course implications of restricted support in the postpartum period, and policy-makers and healthcare providers should continue to explore innovative and patient-centred approaches to improving PNC provision. Future research should continue to evaluate the longer-term impacts of these changes in non-pandemic contexts.

Objectives
Investigate determinants of post-COVID-19 condition (PCC) clinic attendance among participants not hospitalised versus hospitalised during the SARS-CoV-2 infection.

Design
Retrospective cohort study.

Setting
Six population-based registers with high coverage to cover all adults residing in Stockholm County, Sweden.

Participants
Adults residing in Stockholm County on 31 January 2020, with a SARS-CoV-2 infection through 30 November 2022, who did not die or move out of Stockholm County within 90 days.

Primary outcome measures
PCC clinic attendance from 90 days after the SARS-CoV-2 test until date of death, date of moving out, or 30 November 30,2023.

Results
Of non-hospitalised and hospitalised participants, 737 of 464 674 (0.2%) and 433 of 23 374 (1.9%), respectively, attended a PCC clinic. A total of 75 878 (16.3%) of non-hospitalised participants and 6190 (26.5%) of hospitalised participants presented with new-onset symptoms that could indicate PCC in primary care. The strongest determinants of attendance among non-hospitalised participants were mental health disorder (adjusted risk ratio (aRR) 2.57, 95% CI 2.21 to 2.98), asthma (2.39, 1.97–2.92) and >4 PCC symptoms in 2019 (2.27, 1.60–3.24), and among hospitalised participants were >31 sick days in 2019 (1.94, 1.47–2.56), 1–30 sick days in 2019 (1.56, 1.06–2.29) and obesity (1.51, 1.19–1.93). The most common clinical presentation was fatigue (n=526, 71.4%) among non-hospitalised and dyspnoea (n=148, 34.2%) among hospitalised participants.

Conclusions
PCC clinic attendance characteristics differed between non-hospitalised and hospitalised participants. Distinguishing PCC from conditions with overlapping symptoms and determining the appropriate level of care may be challenging, with risk of resource displacement effects and inappropriate care.

Objective
To investigate the epidemiological characteristics and temporal-spatial distribution of Mycoplasma pneumoniae (MP) infections among paediatric inpatients with respiratory tract infections in Tianjin, China, across three distinct phases: pre-pandemic (2017–2019), pandemic (2020–2022) and post-pandemic (2023–2024). The primary hypothesis is that the COVID-19 pandemic altered the epidemiology of MP infections in children.

Design
Retrospective, single-centre study.

Setting
Secondary care paediatric hospital in a metropolitan area.

Participants
A total of 60 213 paediatric patients hospitalised with respiratory infections between January 2017 and December 2024 were included. The study population consisted of children aged 0–18 years, with a male-to-female ratio of 1.22:1.00. Selection criteria included children admitted with a diagnosis of respiratory infection, while those with incomplete clinical data or non-respiratory infections were excluded.

Primary and secondary outcome measures
The primary outcome was the overall positive detection rate of MP-RNA. Secondary outcomes included annual and seasonal variations in MP-RNA detection rates, differences by sex and age group, and the impact of the COVID-19 pandemic on MP epidemiology. All statistical methods, including those used to control for confounding, involved the use of ² tests for comparing positive rates between groups.

Results
The overall positive detection rate of MP-RNA among children hospitalised for respiratory infections during the study period was 36.58% (22 023/60 213). The annual MP-RNA-positive detection rates from 2017 to 2024 were as follows: 50.74% (411/810) in 2017, 36.28% (1150/3170) in 2018, 27.41% (1459/5323) in 2019, 10.18% (222/2181) in 2020, 11.42% (928/8129) in 2021, 13.27% (579/4364) in 2022, 28.97% (3064/10575) in 2023 and 55.38% (14 210/25 661) in 2024. The highest annual positivity rate was observed in 2024 (55.38%, 14 210/25 661), while the lowest rate occurred in 2020 (10.18%, 222/2181). Statistical analysis revealed significant differences in MP-RNA detection rates across different years (²=8331.511, p

Ricoverata per 10 giorni rianimazione a Meyer

“Tutta la famiglia della Segafredo vicina a lui, Forza Achi”

Circolazione su bassi livelli ma immunità popolazione in calo

Nasce rivista ‘la miglior vita possibile’ per promuovere nuovi hospice e lo sviluppo di reti assistenziali domiciliari

This study examines the immunogenicity and safety of an investigational mRNA-based vaccine against seasonal influenza and SARS-CoV-2 in adults 50 years and older.

Introduction
Mental health problems are important causes of disability and economic costs worldwide. Randomised clinical trials examining the treatment of mental health disorders measure heterogeneous outcomes, causing difficulties in data synthesis, interpretation and translation into clinical practice. The aim of the Patient Important Outcomes in Psychiatry (PIO-Psych) Initiative is to develop an overarching, transdiagnostic research-based and consensus-based core outcome set for adult mental health disorders.

Methods and analysis
The development of the PIO-Psych transdiagnostic core outcome set will include three phases: (1) a systematic scoping review of the literature to develop the initial list of outcomes for the Delphi study; (2) a Delphi study in three rounds including people with lived experience of mental health disorders and their relatives, clinicians, researchers and others (administrators, mental healthcare policymakers, philosophers); (3) a hybrid consensus meeting to agree on the final overarching, transdiagnostic core outcome set and corresponding time points of assessment of each outcome.

Ethics and dissemination
Ethical approval is not applicable to this study according to the Research Ethics Committee of the Capital Region of Denmark, as it is not an interventional study. All data will be reported anonymously, and it will not be possible to identify study participants. Results will be disseminated via stakeholder and research networks and peer-reviewed publications.

Trial registration details
The PIO-Psych Initiative was pre-registered with COMET (Core Outcome Measures for Effectiveness Trials) on 17 May 2024 (https://www.comet-initiative.org/Studies/Details/3125).