Search Results for: Follow-up ottimale dopo embolia polmonare acuta

Objective
This study aimed to determine the incidence of attrition and its predictors among HIV-infected adolescents receiving antiretroviral therapy in public hospitals, South Ethiopia.

Study design
A multicentre retrospective follow-up study was conducted, and Cox proportional hazards model was used to identify predictors of the study outcome variable (attrition).

Settings
The study was conducted in eight public hospitals (two general and six primary hospitals) in South Ethiopia.

Participants
Adolescents (10–19 years) on antiretroviral therapy from 1 January 2014 to 30 December 2023 (n=409). The data were collected from patients’ charts and electronic data records.

Outcome variable
The primary outcome was time to attrition, and the secondary outcome was predictors of attrition.

Results
The overall incidence density of attrition was 3.33 (95% CI: 2.65 to 4.18) per 100 person-year of observation. Age 15–19 years (adjusted HR (AHR): 1.88; 95% CI: 1.12 to 3.18), death of both the parents (AHR: 2.19; 95% CI: 1.04 to 4.61), no formal education (AHR: 3.16; 95% CI: 1.48 to 6.77), Co-trimoxazole Prophylactic Therapy (CPT) non-utilisation (AHR: 1.73; 95% CI: 1.03 to 2.91), not changed regimen (AHR: 6.16; 95% CI: 3.56 to 10.66) and poor treatment adherence (AHR: 5.16; 95% CI: 2.35 to 11.32) were predictors of attrition.

Conclusion
Attrition was identified to be a significant public health problem in study settings. Moreover, old age, parental death, not attending formal education, not using CPT, unchanged baseline regimen and suboptimal treatment adherence predict attrition. Hence, special attention should be given to older adolescents, those with no formal education, orphaned and with poor baseline clinical characteristics. Likewise, early tracing of missed follow-up schedules, improving adherence support and increasing contacting frequency to reduce attrition are highly encouraged.

Introduction
Adolescents diagnosed with cancer face unique challenges that can significantly impact their physical, emotional and social well-being. Educational interventions are essential in providing these young patients with the knowledge and skills necessary to navigate their cancer journey effectively. This scoping review aims to map the existing evidence on educational interventions tailored for adolescents with cancer, identifying gaps in the literature and informing future research and practice.

Methods and analysis
The review will follow a systematic scoping review as outlined by the Joanna Briggs Institute. A preliminary search was conducted in June 2024 with the PubMed database. This will be followed by a comprehensive search strategy across multiple databases, including PubMed, SCOPUS, WoS, PsycINFO, GIM and CINAHL, to identify relevant literature published in English. All types of educational interventions targeting adolescents with cancer will be included, while studies focusing on non-cancer populations or published in non-English languages will be excluded. Data extraction will be conducted by two independent reviewers using a standardised tool, and qualitative content analysis will be performed to summarise the findings. The results will be presented in tables and figures, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: Extension for Scoping Reviews guidelines. This scoping review has been registered with Open Science Framework (https://osf.io/7p93v).

Ethics and dissemination
As this scoping review will use secondary data from published literature, ethical approval is not required. The findings will be disseminated through peer-reviewed publications, conference presentations and stakeholder engagement.

Objectives
This study aimed to determine healthcare needs and care use (provision of healthcare) in adults with Bardet–Biedl syndrome (BBS) and the associations between care use and physical functioning, health status outcomes and distress.

Design
Cross-sectional study.

Setting
Outpatient hospital visits.

Participants
30 adults with BBS were included (50% women, aged 20–69 years) and assessed with the Needs and Provision Complexity Scale, Short Physical Performance Battery, EuroQoL five dimensions with five severity levels (EQ-5D-5L) and Hospital Anxiety and Depression Scale.

Results
The majority (80%) received disability benefits, 93% were overweight or obese and all had retinal dystrophy. Unmet needs (needs-gets) were found within the domains of rehabilitation (83%), social and family support (63%), healthcare (50%), personal care (47%) and the environment (40%). Significant correlations were observed between care use (gets) and worse physical performance (=–0.34, p

In Reply In their Letter about our recent article, Dr Back and colleagues highlight a particular sentence in the Table: “Palliative care is not hospice care and it is not giving up,” and indicate that this phrasing may be problematic due to its use of negation. The sentence is an example of an elucidating explanation, a technique that we discussed in the article as a way to clarify a concept by explaining both what it is (affirmation) and what it is not (negation). The negation is not intended to stand alone. Instead, the elucidating explanation is part of a larger conversation about palliative care. In the case we described in the Table, the clinician conversation began in the patient scenario row, including an introduction to palliative care, which would describe what palliative care is (affirmation statement). The elucidating explanation, including the negation statement, then helps patients navigate the information that came in the affirmation statement.

The Original Investigation titled “Neurodevelopmental Outcomes After Late Preterm Antenatal Corticosteroids: the ALPS Follow-Up Study,” published in the May 21, 2024, issue of JAMA, included errors for the Social Responsiveness Scale t scores that were greater than 65, reported in Tables 2 and 3 and in eTable 4 of Supplement 3. This article was corrected online.

We walk past the old, slump block house, & I can’t help but glance at the blinds, drawn down like surrendering eyelids. The front yard has a small, white statue of Mary Magdalene with her palms turned up in what could either be a gesture of welcome or a sign of dismay. Once, as part of a home health care company, I was inside, speaking with a woman who thought I was her grandson. I corrected her the first time, but afterwards, I went along with the story. It was easier. My job was to get her up & walk with her around the home, where residents gazed with peach-pit eyes at the television & waited for a savior to come. We walked on a thin, cement path that lined the backyard, between geraniums arranging their lipstick toward the light. We came to know each other. I learned that she grew up in a small farming town not far from my real grandmother, which explained her familiar tenderness & prolonged drawl. After several days of this, she asked if I would go to her house & check on the roses, like her husband & son had done before they died, tragically, in the same 12 months. I don’t know why, but I did. It was summer, & roses are not a hardy plant. The raised bed held nothing but a crisp, brown carcass. Rather than lie, I bought a 3-gallon rose plant at the nursery & returned with a shovel. That way, I could say Don’t worry, as she breathed more heavily, as the day came she could not leave her bed, they are doing alright. It was true— I’d managed to fix her irrigation, & I shouldn’t have expected, I guess, more than one miracle. So when she died two weeks later, her room a blank slate, all I could think about— & all I can see for a block after passing that house— was that she’d never said goodbye to her grandson & the deep, deep red of those roses.

Hospital occupancy in the US averaged about 75% during a 1-year period between 2023 and 2024, up from the average 64% capacity in the decade before the COVID-19 pandemic. If the hospitalization rate and bed supply don’t change, the US could face a critical hospital bed shortage by 2032, a recent study found.

Introduction
In the management of medication adherence in elderly patients with type 2 diabetes mellitus (T2DM), traditional methods such as verbal guidance and written materials may have certain limitations. Therefore, the development of digital intervention measures may play a key role in addressing these shortcomings. The objective of this study is to investigate the effects of Diabetes Little Helper (DLH) video intervention in improving medication adherence among elderly patients with T2DM in Henan province, China.

Methods and analysis
A parallel cluster randomised controlled trial will be applied in the current study. The two hospitals will be randomly divided into a control group and an intervention group, with 68 patients in each arm. Both groups will receive standard care, meanwhile the intervention group will receive an additional DLH video intervention. Data collection is planned at baseline, 1 month after intervention and at 3-month follow-up. Once the study is completed, the control group will also receive the similar video as in the intervention arm to uphold the ethical issues.

Ethics and dissemination
This study has obtained ethical approval from the Institutional Review Board of University Putra Malaysia (JKEUPM-2023-1279) and Henan Provincial People’s Hospital (20240107). The research results will also be submitted for publication in peer-reviewed journals.

Trial registration number
Chinese Clinical Trial Registry, ChiCTR2400083282.

Il sindacato Nursing Up: “suo abbraccio agli anziani e i malati”

Circulation, Ahead of Print. BACKGROUND:High-volume physical activity (PA) is associated with a higher prevalence of subclinical coronary artery disease (CAD). However, the clinical significance of subclinical CAD among high-volume exercisers remains incompletely understood, and the dose–response relationship between high-volume PA and clinical CAD events remains uncertain.METHODS:Individual participant data from the Cooper Center Longitudinal Study (1987–2018) were linked to Medicare claims files. PA volume was determined by self-report and categorized as

Objectives
Uncertainty exists as to what extent common risk factors are involved in the associations of unemployment with major health outcomes and mortality.

Design
A retrospective and prospective observational study.

Setting
A large population-based French cohort (CONSTANCES).

Participants
99 430 adults at baseline who have been exposed to unemployment during their lifetime and 54 679 of them who were followed for 7 years after baseline.

Primary outcome measures
Testing the mediating roles of several risk factors at baseline in the associations of lifetime unemployment exposure with cardiovascular disease, cancer and mortality rates during a 7-year follow-up. Direct and indirect effects were calculated for each risk factor and all together using logistic regression models adjusted for major confounders including sex, age, parental histories of cardiovascular disease and cancer, social position and working conditions.

Results
Estimates (95% CIs) of the direct and indirect effects for smoking are 0.0083 (0.0044 to 0.0122), p

Objectives
The scaling-up nutrition (SUN) initiative, which was launched in 2010 to eradicate malnutrition in all its forms by 2030, collaborates with a diverse range of stakeholders, such as governments, non-governmental organisations (NGOs), donors, businesses and academia. Given the widespread adoption of this multisectoral approach, it is crucial to explore methods for evaluating the perspectives of multiple stakeholders in child undernutrition topics.

Design
This scoping review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.

Data sources
Six peer-reviewed databases, including PubMed, Web of Science, Cochrane, Embase, CINAHL and PROQUEST ASSIA, were systematically searched.

Eligibility criteria
Original English studies published between 1 January 2010 and 1 June 2023, focusing on undernutrition in SUN countries.

Data extraction and synthesis
Two reviewers independently screened titles, abstracts and full texts for inclusion and extracted data using Rayyan.

Results
Out of the 4533 articles, 19 met the inclusion criteria for the review, and 5 more were added through manual searches. These studies were conducted in 14 SUN countries, with 62% using mixed methods and the remaining using qualitative methods. Six methods were used to gather stakeholder perspectives, including in-depth interviews, focus group discussions, Net-Map, organisational network analysis and Q methodology. Most studies focused on government, development partners and NGOs, while only two studies involved the business network.

Conclusions
Our study indicates that study on stakeholder perspectives in SUN countries focuses mainly on those showing progress in malnutrition/undernutrition reduction. Future research should explore countries with less progress to improve partnership frameworks. The SUN movement should establish a standard method for evaluating stakeholder perspectives, considering both outcomes and processes.

Trial registration number
The final protocol was registered prospectively with the Open Science Framework in July 2023 (https://osf.io/te7cb).

Introduction
Many systematic reviews and meta-analyses (SRs/MAs) have evaluated the efficacy of biologic therapies for severe asthma. However, the overall quality of these SRs/MAs is unclear, which may influence the selection of biologics and lead to misleading clinical decisions. This umbrella review aims to objectively evaluate the overall quality of these SRs/MAs and reassess the efficacy of biologic therapies for severe asthma. Thus, this study will provide reliable evidence for clinical practice.

Methods and analysis
A systematic search will be performed in PubMed, Embase, Cochrane Library, Web of Science, Scopus and conference abstracts up to 1 March 2025. Literature screening and data extraction will be conducted according to predefined inclusion and exclusion criteria. We will evaluate the reporting quality, methodological quality and evidence quality of these SRs/MAs using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, PRISMA for Network Meta-Analysis 2015 checklist, A MeaSurement Tool to Assess Systematic Reviews 2, Cochrane Risk of Bias 1.0 and Grading of Recommendations Assessment, Development and Evaluation system. Additionally, the re-analysis of outcomes will be performed using R software (V.4.3.3).

Ethics and dissemination
Since this umbrella review will use publicly available data, ethics approval is not required. The results of this study will be disseminated through publication in a peer-reviewed journal.

PROSPERO registration number
CRD42024607393.

Ghebreyesus: “Siamo ancora nella fase acuta di questa epidemia”

Ghebreyesus: “Siamo ancora nella fase acuta di questa epidemia”

Stroke, Ahead of Print. BACKGROUND:Neonatal hypoxic-ischemic (HI) brain injury is one of the leading causes of long-term neurological morbidity in newborns. Current treatment options for HI brain injury are limited, but mesenchymal stem cell (MSC) therapy is a promising strategy to boost neuroregeneration after injury. Optimization strategies to further enhance the potential of MSCs are under development. The current study aimed to test the potency of hypoxic preconditioning of MSCs to enhance the therapeutic efficacy in a mouse model of neonatal HI injury.METHODS:HI was induced on postnatal day 9 in C57Bl/6 mouse pups. MSCs were cultured under hypoxic (hypoxic-preconditioned MSCs [HP-MSCs], 1% O2) or normoxic-control (normoxic-preconditioned MSCs, 21% O2) conditions for 24 hours before use. At 10 days after HI, HP-MSCs, normoxic-preconditioned MSCs, or vehicle were intranasally administered. Gold nanoparticle–labeled MSCs were used to assess MSC migration 24 hours after intranasal administration. At 28 days post-HI, lesion size, sensorimotor outcome, and neuroinflammation were assessed by hematoxylin and eosin staining, cylinder rearing task, and IBA1 staining, respectively. In vitro, the effect of HP-MSCs was studied on transwell migration, neural stem cell differentiation and microglia activation, and the MSC intracellular proteomic content was profiled using quantitative LC-MS/ms.RESULTS:Intranasally administered HP-MSCs were superior to normoxic-preconditioned MSCs in reducing lesion size and sensorimotor impairments post-HI. Moreover, hypoxic preconditioning enhanced MSC migration in an in vitro set-up, and in vivo to the lesioned hemisphere after intranasal application. In addition, HP-MSCs enhanced neural stem cell differentiation into more complex neurons in vitro but had similar anti-inflammatory effects compared with normoxic-preconditioned MSCs. Lastly, hypoxic preconditioning led to elevated abundances of proteins in MSCs related to extracellular matrix remodeling.CONCLUSIONS:This study shows for the first time that hypoxic preconditioning enhanced the therapeutic efficacy of MSC therapy in a mouse model of neonatal HI brain injury by increasing the migratory and neuroregenerative capacity of MSCs.