Search Results for: Nuovi farmaci per il danno renale acuto (Acute kidney injury – AKI)

Farmaci e vaccini sono al primo posto in Italia per surplus con l’estero, con oltre 21 miliardi di attivo nel 2024, mentre i nuovi record di produzione (56 miliardi) ed…

New England Journal of Medicine, Volume 393, Issue 1, July 3, 2025.

Objectives
To evaluate how insurance influences the risk of a dementia diagnosis among a large, diverse cohort of US civilian adults with traumatic brain injury (TBI) over a 22-year period.

Design
This is a retrospective cohort study involving individuals diagnosed with TBI.

Setting
The study used the Merative MarketScan Research Database, specifically drawing from the Commercial Claims and Encounters, Medicare Supplemental and Medicaid databases, from 2000 to 2022 in the USA. These databases provide comprehensive insights into healthcare services received by enrollees, including inpatient and outpatient services, outpatient prescription claims, clinical utilisation records and healthcare expenditures.

Participants
267 473 adults aged 55 and older who were diagnosed with a TBI between 1 January 2000 and 31 December 2022. Individuals with unknown TBI severity and dementia claims 2 years preceding TBI were excluded. TBI and dementia diagnoses were identified using International Classification of Disease 9th and 10th editions codes from inpatient and outpatient admission records.

Interventions
None.

Primary and secondary outcome measures
We compared the incidence of all-cause dementia across different insurance types to assess potential disparities in diagnosis following TBI. Cox proportional hazards models, with age as the time scale, were used to study the association between insurance type and dementia diagnosis following a TBI. Models were adjusted for key demographic variables, medical comorbidities and psychiatric conditions to account for potential confounding.

Results
Of the 267 473 individuals with TBI, 12.7% were diagnosed with dementia over a mean follow-up period of 40 months (SD of 42 months). Dementia incidence differed significantly by insurance type, with 18.2% for Medicaid recipients, 17.3% for Medicare beneficiaries and only 2.3% among individuals with commercial insurance. The adjusted HR for dementia was notably higher among individuals enrolled on Medicaid (HR 2.9, 95% CI: 2.8 to 3.1) and Medicare (HR 2.1, 95% CI: 2.0 to 2.2), when compared with those with commercial insurance.

Conclusions
Individuals with TBI covered by Medicaid and Medicare are significantly more likely to be diagnosed with dementia, with a 2.9-fold and 2.1-fold increase risk, respectively, compared with those with commercial insurance. Addressing insurance-related disparities in dementia diagnosis is crucial for building a more equitable healthcare system. It is essential that individuals with TBI cases, regardless of their insurance type, have access to comprehensive care and preventive interventions to achieve the best possible long-term outcomes.

Introduction
Amoxicillin is recommended for children with uncomplicated severe acute malnutrition (SAM). However, some trials have shown no difference in amoxicillin for nutritional recovery in children with SAM compared with placebo. In addition, amoxicillin treatment requires two times per day dosing for 7 days, which may influence adherence. Azithromycin is a broad-spectrum antibiotic that can be provided as a single dose and has reduced mortality in children aged 1–59 months when provided by mass drug administration. The AMOUR trial is designed to assess amoxicillin, azithromycin and placebo as part of outpatient treatment of uncomplicated SAM.

Methods and analysis
This double-masked randomised controlled trial will enrol 3000 children over 3 years in an individually randomised 1:1:1 allocation to azithromycin, amoxicillin or placebo arms and follow them for 12 months. Children eligible to enrol in the study will be aged 6–59 months and have uncomplicated non-oedematous SAM as defined by weight-for-height Z-score

Objective
This study aimed to assess the pattern of disease and predictors of mortality among critically ill geriatric patients admitted to the intensive care unit at a teaching hospital.

Design
A single-centre retrospective cohort study.

Setting
Medical-surgical intensive care unit of Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia.

Participants
We enrolled 296 critically ill patients (age 60+) admitted to the intensive care unit who stayed for more than 2 hours. Those patients with missing or incomplete records were excluded.

Primary outcome measure
The primary outcome of this study was the time to death within 30 days following intensive care unit admission.

Results
In this cohort, the overall mortality rate of geriatric patients in the intensive care unit was found to be 42.9%. The incidence rate of mortality was 6.3 deaths per 100 person-days observation. Acute kidney injury (adjusted HR=2.36, 95% CI: 1.16, 3.68), coexisting diseases (adjusted HR=1.66, 95% CI: 1.13, 2.42), the presence of shock (adjusted HR=2.27, 95% CI: 1.66, 4.53) and mechanical ventilation (adjusted HR=1.82, 95% CI: 1.14, 2.89) were predictors of mortality in the intensive care unit.

Conclusions
The mortality rate in the intensive care unit among geriatric patients was high. Predictors of mortality in this population of critically ill geriatric patients included acute kidney injury, the presence of shock, coexisting diseases and mechanical ventilation in the intensive care unit.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

In Olanda è già adottato per guidare la prescrizione dei farmaci e anche in Italia cresce l’interesse per la farmacogenetica, che può prevenire effetti collaterali e fallimenti terapeutici

This study compares proportions of facilities receiving penalties based on stratified benchmarks in the Centers for Medicare & Medicaid Services’ End-Stage Renal Disease Treatment Choices (ETC) model, a pay-for-performance program incentivizing home dialysis and kidney transplant waitlisting.

To the Editor A recent Editorial by editors representing the International Committee of Medical Journal Editors (ICMJE) highlighted the pressing issues surrounding predatory journals. Although the challenges posed by predatory journals are not new, they are becoming increasingly acute. Although some resources are in place to help counter their activities, we believe that the ICMJE could further address these issues. The ICMJE’s current practice of listing journals that self-declare adherence to the ICMJE recommendations may be exploited by predatory journals because this declaration does not guarantee adherence to the required standards.

This JAMA Insights discusses the FDA approval of remestemcel-L-rknd to treat graft-vs-host disease in children and provides regulatory considerations for this approval.

This individual participant data meta-analysis compares the association between antipsychotic (vs placebo) acute-phase treatment and outcomes in individuals who were not recently treated to recently treated individuals.

This cohort study evaluates the association between sodium-glucose cotransporter 2 inhibitors and hyperkalemia in individuals with diabetes, heart failure, or chronic kidney disease receiving renin-angiotensin-aldosterone system inhibitors.

To the Editor The solutions proposed by Ms Istvan and colleagues for the administrative costs plaguing US health care will not meaningfully improve timely access to medically necessary care for individuals, or reduce moral injury among clinicians. Administrative burdens arise from obstruction by design.