Risultati per: Probiotici: in vivo vs in vitro

Annals of Internal Medicine, Volume 178, Issue 2, Page JC19, February 2025.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Volume 178, Issue 2, Page JC15, February 2025.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Volume 178, Issue 2, Page JC14, February 2025.

This randomized clinical noninferiority trial investigates whether a brief online self-guided cognitive behavioral therapy intervention is noninferior to a comprehensive online clinician-guided cognitive behavioral therapy treatment.

This randomized clinical trial investigates the effectiveness of integrative cognitive behavioral therapy vs present-centered therapy in patients with prolonged grief disorder.

To the Editor The Original Investigation by Rodriguez et al compared the effectiveness of semaglutide and tirzepatide, each labeled for type 2 diabetes (T2D), in promoting weight loss among adults with overweight or obesity. Tirzepatide was associated with greater weight loss than semaglutide. However, the study did not account for differences in dosages, despite the known dose-response relationship with weight loss for both medications. Accounting for dosage is especially important given that only formulations labeled for T2D were assessed. Consequently, it is likely that semaglutide users receiving the 2.4-mg dosage regimen—the higher dosing recommended only for weight loss—were excluded.

To the Editor Giannakeas et al analyzed patients with breast cancer using Surveillance, Epidemiology, and End Results (SEER) data and concluded that bilateral mastectomy reduced the risk of contralateral breast cancer but did not improve breast cancer mortality. Their novel but perplexing finding is that contralateral cancers increased the risk of breast cancer mortality. They discussed the possibility that contralateral cancers may represent metastases; however, prior studies on clonality have found this to be uncommon.

This phase 3 randomized clinical trial evaluates whether stereotactic body radiation therapy improves outcomes in patients with locally advanced hepatocellular carcinoma compared with sorafenib alone.

In Reply O’Keefe and colleagues raise salient points regarding the interpretation of the data presented in our article on bilateral mastectomy and the risk of breast cancer mortality. In this article, we showed that experiencing a contralateral cancer greatly increased the mortality rate, but preventing contralateral breast cancer with bilateral mastectomy did not mitigate the risk. The authors propose that residual confounding due to variables that are unaccounted for in the Surveillance, Epidemiology, and End Results (SEER) database are a plausible explanation for this apparent enigma.

In Reply We appreciate the commentary by Levy et al related to our comparative effectiveness study of semaglutide and tirzepatide, with the suggestion that a direct comparison be made between the 2 drugs by dosage regimen. Although we agree that dosages plays a critical role in weight change outcomes, dose comparisons were intentionally omitted from our study because of the potential for bias. Dose-response relationships have been assessed in randomized clinical trials in which doses are assigned at baseline. However, in real-world settings, where doses are escalated over time based on tolerability and response, dose comparisons may threaten internal and external validity.

Stroke, Volume 56, Issue Suppl_1, Page ATMP35-ATMP35, February 1, 2025. Introduction:Studies have suggested efficacy of glycoprotein IIb/IIIa antagonists such as tirofiban for patients with acute ischemic stroke (AIS). However, neurological deterioration is still common in many of the recommended antiplatelet regimens. We aimed to evaluate the efficacy and safety of tirofiban versus dual antiplatelet therapy (DAPT) or aspirin in patients with AIS.Methods:Following PRISMA guidelines, we searched Pubmed, Embase, Scopus and Cochrane databases for studies comparing effects of tirofiban versus DAPT or aspirin alone in patients with AIS. Main outcomes were increase in NIHSS score, Modified Rankin Scale (mRS) scores at 90 days (0 to 2), intracranial hemorrhage (ICH) and mortality. Statistics analysis was performed using Review Manager 5.4.1 software. Heterogeneity was assessed with I2statistics.Results:We included 5 RCT and 5 non-RCT studies covering 1,857 patients, of whom 926 were treated with Tirofiban. Neurological deterioration, assessed by changes in NIHSS scores from baseline across four studies, was less pronounced in the Tirofiban group (MD -0.32; 9% CI -0.83-0.19; p

Stroke, Volume 56, Issue Suppl_1, Page ATMP26-ATMP26, February 1, 2025. Introduction:Telestroke has the potential to revolutionize acute stroke treatment by improving access to optimal stroke care, including time-sensitive care such as thrombolysis. Yet few studies have compared acute stroke treatment metrics and outcomes in patients treated using telestroke versus standard in-person stroke evaluation.Methods:This was a retrospective cohort study of acute ischemic stroke patients age ≥18 presenting to 53 Paul Coverdell Michigan hospitals between 2022 and 2023 who were potentially eligible for thrombolysis (i.e., presented ≤ 4 hours of last known well, no contraindications to thrombolysis). The primary exposure was telestroke (vs non-telestroke), and primary outcomes were receipt of thrombolysis and door-to-needle (DTN) time. Secondary outcomes included discharge ambulatory status and door-in-door-out (DIDO) time in transferred patients. Multivariable hierarchical models evaluated associations between the telestroke (vs. non-telestroke) activation and outcomes, sequentially adjusted for demographics, medical history, presenting/arrival, and hospital characteristics.Results:Among the 4974 stroke patients potentially eligible for thrombolysis (mean age 69.2 [SD: 14.6], 48.3% female), 1078 (21.7%) were evaluated using telestroke and 3896 (78.3%) without telestroke. Telestroke patients were more commonly at primary stroke centers (71.1% vs 39.0%) and less at comprehensive stroke centers (13.3% vs 53.9%; P

Stroke, Volume 56, Issue Suppl_1, Page ATMP65-ATMP65, February 1, 2025. Background:We aimed to evaluate whether the implementation of regional prehospital transport to comprehensive stroke center (CSC) protocol has any impact on inter-hospital transfer rate and neurologic outcomes of intracranial hemorrhage (ICH) patients.Methods:We performed a retrospective multicenter study comparing outcomes in patients with ICH arriving at 15 Primary Stroke Centers (PSC) and 8 CSC in Chicago, Illinois via emergency medical services transport from January 1 2017 and December 31 2023 – before and after implementation of a prehospital transport protocol in September 2018 which uses a 3-item stroke scale to identify patients with more severe stroke types and