Risultati per: Quali armi contro l'infiammazione alla base dell'artite psoriasica?

Message Thermal ablation of resection margins has been shown to reduce recurrence after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal polyps, however, to a variable extent. In addition, residual or recurrent adenoma (RRA) may also arise from remnants in the resection base. We present a combined technique of margin and base ablation using submucosal injection followed by low energy argon beamer coagulation: Of 113 cases treated this way, RRA was found in one case only (0.9%). These data from multicentre registries were significantly lower compared with cases with margin ablation only (n=170; RRA rate 8.8%) or cases without (n=144; RRA rate 23.4%) in the same databases. This difference persisted when analysing only large lesions ≥40 mm (2.4 vs 12.5 vs 28.1%; overall n=137). Bleeding and perforation rates were similar across all groups. In more details Significant efforts have been expended to reduce RRAs after EMR. Thermal…

Dagli anticorpi all’intelligenza artificiale, cosa sta cambiando la vita dei pazienti

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

Circulation, Ahead of Print. BACKGROUND:Pathogenic variants inSCN5Acan result in long QT syndrome type 3, a life-threatening genetic disease. Adenine base editors can convert targeted A T base pairs to G C base pairs, offering a promising tool to correct pathogenic variants.METHODS:We generated a long QT syndrome type 3 mouse model by introducing the T1307M pathogenic variant into theScn5agene. The adenine base editor was split into 2 smaller parts and delivered into the heart by adeno-associated virus serotype 9 (AAV9-ABEmax) to correct the T1307M pathogenic variant.RESULTS:Both homozygous and heterozygous T1307M mice showed significant QT prolongation. Carbachol administration induced torsades de pointes or ventricular tachycardia for homozygous T1307M mice (20%) but not for heterozygous or wild-type mice. A single intraperitoneal injection of AAV9-ABEmax at postnatal day 14 resulted in up to 99.20%Scn5atranscripts corrected in T1307M mice.Scn5amRNA correction rate >60% eliminated QT prolongation;Scn5amRNA correction rate

Assemblea legislativa carioca li approva per le famiglie povere

Assemblea legislativa carioca li approva per le famiglie povere

Circulation, Volume 148, Issue Suppl_1, Page A16419-A16419, November 6, 2023. Introduction:Oncology societies have been contributing guidelines/recommendations to the limited yet growing body of literature in cardio-oncology.Research Questions:What are the levels of evidence (LOE) and classes of recommendation (COR) for cardiology-specific recommendations produced by major oncology societies?Methods:We reviewed cardiology-specific recommendations published by the American Society of Clinical Oncology (ASCO), American Society of Hematology (ASoH), NCCN (National Comprehensive Cancer Network), and European Society of Cardiology (ESC). LOE and COR were noted for each recommendation.Results:The US oncologic societies have made 81 cardiac-specific recommendations (ASCO: 54 (67%); ASoH: 14 (17%); NCCN; 13 (16%) (Tables 1-3). For ASCO, 26 (48%) were COR 1, 23 (43%) COR 2, and 5 (9%) COR 3 supported by LOE A (9%), LOE B (39%), and LOE C (52%). For ASoH, 1(8%) was COR 1, 11(85%) COR 2, and 1(8%) COR 3 supported by LOE B (7%), and LOE C (93%). NCCN made 13 COR 2 recommendations and did not provide LOE classification. The most common recommendations addressed baseline (20%) and serial (24%) assessment, specific imaging modalities (9%), chemotherapy dosing (19%), and radiation therapy (20%). Most recommendations were unique without discrepant statements, but there were some redundancies. ESC produced 271 cardio-oncology recommendations (155 COR 1; 111 COR 2; 5 COR-3) with 3% LOE A, 21% LOE B, and 76% LOE C. The major areas for ESC recommendations included baseline (18%) and serial (33%) assessment, and medications (29%).Conclusions:Oncology and cardiology professional society guidelines have provided 352 cardiac related recommendations in the setting of cancer treatment and 73% have the lowest LOE. In this developing field with a limited evidence base, close collaboration between cardiologists and oncologists will be required to provide a cohesive set of recommendations for the cardiac issues associated with cancer treatment.

Sindacato Aupi: ‘dopo l’approvazione della Regione Sicilia’

Sindacato Aupi: ‘dopo l’approvazione della Regione Sicilia’

Objectives
Same day emergency care (SDEC) is a new model of care, which has emerged over the past 5 years, building on prior ambulatory care services. The National Health Service (NHS) England National Strategy for SDEC suggests SDEC can meet local health needs by providing alternatives to emergency department attendance or hospital admission, for people with an urgent healthcare need, beyond the limited scope of an urgent treatment centre. This review focuses on acute medical SDEC, as medical patients represent a significant proportion of emergency admissions. The planned scoping review aims to map the existing evidence base.

Methods and analysis
This is a protocol for a scoping review to be conducted in accordance with the format of the Joanna Briggs Institute (JBI) methodology for scoping reviews. The databases to be searched will include EMBASE, MEDLINE and CINAHL, via EBSCOhost. Sources of unpublished studies, policies and grey literature will include Google Scholar, the Cochrane Library, TRIP database, ProQuest Dissertations and Theses Open, and the Health Management Information Consortium. Papers relating to acute medicine adult patients attending NHS SDEC services in the UK will be included. International papers will be excluded, as will those over 5 years old, and those where full text is not available. The results of the search and study inclusion/exclusion process will be reported and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram. Data will be extracted from papers included in the scoping review by two reviewers, using a JBI data extraction tool. Any differences of opinion will be discussed until consensus is reached. If needed, a third reviewer will be asked to join the review team to achieve consensus. Data and themes extracted will be summarised and presented in tables. A narrative thematic summary will accompany the presented results, describing how the results relate to the review objective. Literature gaps will be identified and recommendations for future research made.

Ethics and dissemination
There is no requirement for ethical approval for this scoping review. On completion, it will be published in a peer-reviewed academic journal and presented at a conference.

Circulation, Ahead of Print. BACKGROUND:Cardiovascular diseases are the main cause of worldwide morbidity and mortality, highlighting the need for new therapeutic strategies. Autophosphorylation and subsequent overactivation of the cardiac stress-responsive enzyme CaMKIIδ (Ca2+/calmodulin-dependent protein kinase IIδ) serves as a central driver of multiple cardiac disorders.METHODS:To develop a comprehensive therapy for heart failure, we used CRISPR-Cas9 adenine base editing to ablate the autophosphorylation site of CaMKIIδ. We generated mice harboring a phospho-resistant CaMKIIδ mutation in the germline and subjected these mice to severe transverse aortic constriction, a model for heart failure. Cardiac function, transcriptional changes, apoptosis, and fibrosis were assessed by echocardiography, RNA sequencing, terminal deoxynucleotidyl transferase dUTP nick end labeling staining, and standard histology, respectively. Specificity towardCaMKIIδgene editing was assessed using deep amplicon sequencing. Cellular Ca2+homeostasis was analyzed using epifluorescence microscopy in Fura-2–loaded cardiomyocytes.RESULTS:Within 2 weeks after severe transverse aortic constriction surgery, 65% of all wild-type mice died, and the surviving mice showed a dramatically impaired cardiac function. In contrast to wild-type mice, CaMKIIδ phospho-resistant gene-edited mice showed a mortality rate of only 11% and exhibited a substantially improved cardiac function after severe transverse aortic constriction. Moreover, CaMKIIδ phospho-resistant mice were protected from heart failure–related aberrant changes in cardiac gene expression, myocardial apoptosis, and subsequent fibrosis, which were observed in wild-type mice after severe transverse aortic constriction. On the basis of identical mouse and human genome sequences encoding the autophosphorylation site ofCaMKIIδ, we deployed the same editing strategy to modify this pathogenic site in human induced pluripotent stem cells. It is notable that we detected a >2000-fold increased specificity for editing ofCaMKIIδcompared with otherCaMKIIisoforms, which is an important safety feature. Although wild-type cardiomyocytes showed impaired Ca2+transients and an increased frequency of arrhythmias after chronic β-adrenergic stress,CaMKIIδ-edited cardiomyocytes were protected from these adverse responses.CONCLUSIONS:Ablation of CaMKIIδ autophosphorylation by adenine base editing may offer a potential broad-based therapeutic concept for human cardiac disease.

‘Si corona un sogno’, dice il 25enne che ha risposto all’appello

To the Editor The Editorial by Hoerger and colleagues published recently in JAMA Oncology outlined 10 health care strategies to support patients who are vulnerable during the COVID-19 pandemic. We agree that strategies for protection are needed, but these strategies should be evidence based, which the 10 recommendations are not.

In Reply People with cancer experience an increased risk of SARS-CoV-2 vaccine nonresponse and infection, treatment delays from active infection, COVID-19 hospitalization, post–COVID-19 condition (long COVID), and COVID-19 mortality. Accordingly, in our Editorial, we encouraged cancer centers to provide more comprehensive pandemic support, suggested 10 evidence-based recommendations, and offered volunteer assistance.

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