Risultati per: Approccio farmacologico al trattamento della stipsi indotta da oppioidi: focus su naldemedina

E-cigarettes, which were introduced in the US market in 2007, have experienced tremendous growth in the US and globally and are the focus of an intense and often controversial public health debate concerning harms and benefits. The most important potential benefit of e-cigarettes is to assist with cigarette smoking cessation and reduce exposure to cigarette-related harm among those who completely switch to e-cigarettes. However, e-cigarettes can also produce harm and serve to initiate and maintain nicotine addiction in populations for whom there is no potential public health benefit of use. Indeed, e-cigarette use prevalence is highest and rising among youth and young adults, many of whom have never smoked cigarettes. Among cigarette smokers, dual use of e-cigarettes and cigarettes is common, and many who had successfully quit smoking in the past are reinitiating nicotine use with e-cigarettes. Many youth and adults who use e-cigarettes experience nicotine addiction and physical dependence and are keen to quit e-cigarettes. However, in the national and worldwide discourse about the public health benefits vs harm of e-cigarettes there has been minimal focus on how to support individuals who want to stop using e-cigarettes, leading to a critical lack of evidence-based treatments.

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Objective
To investigate the views, hopes and concerns of patients living with glaucoma and age-related macular degeneration (AMD) regarding vision home-monitoring.

Design
Qualitative study using focus groups and questionnaires. Participants were given three disease-relevant home-monitoring tests to try. The tests consisted of three visual field tests for the glaucoma groups (Melbourne Rapid Fields, Eyecatcher, Visual Fields Fast) and three acuity and/or contrast-sensitivity tests for AMD groups (Alleye, PopCSF, SpotChecks). Focus group data were thematically analysed.

Setting
University meeting rooms in London, UK.

Participants
Eight people with glaucoma (five women, median age 74) and seven people with AMD (four women, median age 77) volunteered through two UK-based charities. Participants were excluded if they did not self-report a diagnosis of glaucoma or AMD or if they lived further than a 1-hour travel distance from the university (to ensure minimal travel burden on participants).

Results
Six themes emerged from focus groups, the two most frequently referenced being: ‘concerns about home-monitoring’ and ‘patient and practitioner access to results’. Overall, participants believed home-monitoring could provide patients with a greater sense of control, but also expressed concerns, including: the possibility of home-monitoring replacing face-to-face appointments; the burden placed on clinicians by the need to process additional data; struggles to keep up with requisite technologies; and potential anxiety from seeing worrying results. Most devices were scored highly for usability, though several practical improvements were suggested.

Conclusion
Patients with mild-to-moderate glaucoma/AMD expect vision home-monitoring to be beneficial, but have significant concerns about its potential implementation.

This Viewpoint from the FDA discusses how pragmatic clinical research—assessment that uses real-world data, often in combination with research data, after initial marketing approval—can help in evaluation of new technologies, benefit research sites in underresourced settings, and better inform regulatory decisions and clinical practice.

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