Risultati per: Polmonite acquisita in comunità (CAP)

Comunicato del 22/03/2024 n°17

In oltre un terzo non è ancora attivata la presenza di camici bianchi, nelle altre solo per alcune ore e meno della metà sono aperte sette giorni

In Reply We appreciate the Letter by Drs Leavens and Wagener in response to our Viewpoint that raised issues for the US Food and Drug Administration (FDA) to consider as it strives to regulate e-cigarettes.

To the Editor The proposal to cap nicotine concentrations in combustible cigarettes is based on sound scientific evidence that cigarettes with very low levels of nicotine will significantly reduce smoking- and tobacco-related harm. However, we believe that a proposal presented in a recent Viewpoint for a federal nicotine cap on e-cigarettes is misguided and runs contrary to current evidence. The focus on e-liquid nicotine concentrations alone is problematic because these restrictions fail to consider that e-cigarettes, unlike cigarettes, offer users ways beyond nicotine concentrations to control nicotine delivery, including manipulating device power and compensatory puffing. In fact, the best evidence suggests that this proposed policy would lead to a product that is as addictive as e-cigarettes with higher nicotine concentrations, which may be more appealing to young people, and more harmful.

A partire dal 16 gennaio nei Poliambulatori dei due paesi

Gimbe, rispetto al primo Pnrr tagliate 500 strutture. Gemmato, altri fondi

Scompaiono quasi 500 strutture territoriali

Ad oggi sono aperte solo il 13% delle Case di Comunità previste dal Pnrr e all’interno i mmg sono presenti solo nel 6,5% dei casi

Fiaso,progetti sul territorio in fase avanzata solo in una su 10

Circulation, Volume 148, Issue Suppl_1, Page A13863-A13863, November 6, 2023. Background:It was recently reported that thin-cap fibroatheroma (TCFA) detected by optical coherence tomography (OCT) was an independent predictor of future cardiac events in patients with diabetes mellitus. However, OCT requires invasive procedure including intracoronary imaging. Computed tomography angiography (CTA) characteristics of TCFA have not been systematically studied.Aims:The aim of this study was to investigate CTA characteristics of TCFA in patients with diabetes mellitus.Methods:Patients with diabetes mellitus who underwent pre-intervention CTA and OCT were enrolled. Non-culprit lesions with a diameter stenosis of ≥30% on angiogram were assessed. Plaque volume and high-risk plaque (HRP) features were evaluated by CTA.Results:Among 132 plaques in 106 patients with diabetes mellitus, 31 plaques had TCFA. Fibrofatty and necrotic core (FF + NC) volume (-30 to 130 HU) was higher in TCFA than in non-TCFA (125.5 mm3vs. 59.4 mm3, p

Circulation, Volume 148, Issue Suppl_1, Page A18944-A18944, November 6, 2023. Introduction:In March 2023, insulin manufacturers in the United States announced price reductions, with Eli Lilly adding a $35 OOP cap on their unbranded insulin products.Aims:To investigate estimated OOP savings of a $35 insulin cap for non-Medicare patients.Methods:We used the 2019 Medical Expenditure Panel Survey (MEPS). Non-Medicare adults aged 18-64 who filled at least one insulin prescription were included. We identified insulin prescriptions with OOP spending above $35 and estimated savings using a $35 OOP cap. For each respondent, we calculated annual insulin OOP spending, average OOP spending per prescription, and total estimated OOP savings with a $35 OOP cap. Analyses were done in SAS.Results:Over 4.1 million non-elderly civilians filled 32.7 million insulin prescriptions in 2019, totaling $1.7 billion in OOP costs, or $418 per person (Table 1). There were 1.6 million people (39.5%) eligible for reduced OOP spending under a $35 OOP cap. Those eligible were more often male and medium- or high-income. Only 16% of publicly insured patients were eligible for savings with a $35 OOP cap, compared to 53% among privately insured and 52% among uninsured groups. Of those eligible for savings, we estimated a $35 OOP cap would have reduced average annual OOP insulin spending from $984 to $231, saving an estimated $1.2 billion. Uninsured patients would see a 93% reduction in OOP spending. Hispanic patients would see an 87% reduction in OOP spending, compared to 73% among non-Hispanic patients. Near poor and low-income patients would see greater OOP reductions than patients in other income groups.Conclusions:Populations most likely to benefit under a $35 OOP insulin cap are those with the highest cost-sharing requirements, such as the uninsured and those just above the threshold for income-based social services. Future work should assess how insulin OOP caps affect patient adherence and outcomes.

Circulation, Volume 148, Issue Suppl_1, Page A14481-A14481, November 6, 2023. Background:Adeno-associated virus (AAV) based gene therapy bears the potential to transform future clinical care of hereditary and acquired heart failure. However, the broadly used AAV9 serotype exhibits fatal liver toxicity in clinical studies and requires long-term immunosuppressive therapy when used systemically e.g., for LAMP2 gene-associated cardiomyopathy.Hypothesis:AAVs with genetically-engineered cardiac tropism are key for safe and efficient delivery of therapeutic gene replacement, silencing or editing systems to the diseased heart with minimized off-target organ transduction after a simple systemic administration.Technology & Results:We developed novel cardiac-specific AAV capsids by a next-generation experimental-bioinformatic AAV capsid development platform (next-CAP) employing mouse, farm pig and non-human primate models. A highly diverse capsid library with more than 100 million variants was generated from novel mammalian heart AAV isolates integrating DNA shuffling and peptide display approaches and underwent a two-step cross-speciesin vivoevolution. Implementing a unique molecular identifier strategy eventually allowed for combined long- and short-term sequencing to capture 77 novel AAV capsid variants displaying highest enrichment in hearts over all other organs, including the liver with superior patterns to AAV9. Subgroups of the top heart-AAV capsid portfolio displayed an overall sequence homology of up to 99.5% identity highlighting the presence of novel cross-species conserved heart-homing motifs. As producibility was another inherent screening criteria, our cardiac-specific AAV capsid portfolio already provides scalable manufacturing characteristics for in vivo indications.Conclusion:Our proprietary portfolio of novel heart-specific AAV capsids now enables the systematic development of optimal therapeutic capsid-promoter-transgene ensembles for further dose-expression, -efficacy and -toxicity assessments for various hereditary and acquired HF indications in suitable model systems. In summary, we developed an efficient and versatile platform for the generation of next-generation AAV capsids for heart-specific gene therapy of yet uncurable rare and common cardiac diseases.