Risultati per: Nuovo test per lo screening del cancro alla prostata

E’ partner del progetto ‘European cancer imaging – Eucaim’

Purpose
The prospective Viral load Cohort North-East Lesotho (VICONEL) aims to support clinical management and generate scientific evidence to inform HIV care. Specifically, VICONEL allows for the monitoring of HIV treatment outcomes and health system performance, encompasses a biobank for further research with routinely collected blood plasma samples of consenting participants and provides a valuable framework for nested observational and interventional studies.

Participants
VICONEL captures routine viral load test results alongside associated demographic and treatment information among people in care for HIV in Lesotho, southern Africa. As of December 2023, it encompasses all viral load testing from 24 healthcare facilities in two districts of Lesotho.

Findings to date
From January 2016 to December 2023, 137 660 viral load test results were available for 29 380 participants. At the time of the last viral load test, median age was 42 years (IQR: 33–53); 18 511 (63%) were adult women, 10 029 (34%) adult men and 835 (3%) children

Objectives
There is increasing interest in guiding atrial fibrillation (AF) screening by risk rather than age. The perceptions of healthcare professionals (HCPs) towards the implementation of risk prediction models to target AF screening are unknown. We aimed to explore HCP perceptions about using risk prediction models for this purpose, and how models could be implemented.

Design
Semistructured interviews with HCPs engaged in the Future Innovations in Novel Detection of AF (FIND-AF) study. Data were thematically analysed and synthesised to understand barriers and facilitators to AF screening and guiding screening using risk assessment.

Setting
Five primary care practices in England taking part in the FIND-AF study.

Participants
15 HCPs (doctors, nurses/nurse practitioners, healthcare assistants, receptionists and practice managers).

Results
Participants knew the health implications of AF and were supportive of the risk prediction models for AF screening. Four main themes developed: (1) health implications of AF, (2) positives and negatives of risk prediction in AF screening, (3) strategies to implement a risk prediction model and (4) barriers and facilitators to risk-guided AF screening. HCPs thought risk-guided AF screening would improve patient outcomes by reducing AF-related stroke, and this outweighed concerns over health anxiety and the impact on workload. Pop-up notifications and practice worklists were the main suggestions for risk-guided screening implementation and for this to be predominantly run by administrative staff. Many recommended the need for educating staff on AF and the prediction models to help aid the implementation of a clear protocol for longitudinal follow-up of high-risk patients and communication of risk.

Conclusions
Overall, HCPs participating in the FIND-AF study were supportive of using risk prediction to guide AF screening and willing to take on extra workload to facilitate risk-guided AF screening. The best pathway design and the method of how risk is communicated to patients require further consideration.

Trial registration number
NCT05898165.

Ast Pesaro-Urbino presenta i numeri del territorio

‘Gli strumenti ci sono ma bisogna applicarli’

Lungo post della modella che sarà sul palco di Sanremo

Oncologi,ma meno del 50% cittadini riceve consigli su stili vita

A hospitalized patient in Louisiana has the nation’s first severe illness with highly pathogenic avian influenza A(H5N1) virus, or H5N1 bird flu, the US Centers for Disease Control and Prevention (CDC) announced in mid-December. Testing revealed that the virus that infected the patient is related to those circulating in wild birds and poultry. The person had contact with sick and dead birds in backyard flocks and, according to news reports, was an older adult with underlying medical conditions.

In the US, cancer prevention and screening have saved more lives from 5 types of cancer combined than treatment advances over the past 45 years, according to a modeling study published in JAMA Oncology. An estimated 5.9 million breast, cervical, colorectal, lung, and prostate cancer deaths were avoided from 1975 to 2020 due to prevention, screening, and treatment efforts, but prevention and screening alone were responsible for averting about 4.8 million—4 out of 5—of those deaths.

Un prelievo scova i cibi a rischio e la gravità della reazione

Introduction
Pre-eclampsia is a condition associated with significant maternal and neonatal morbidity and mortality. The prediction of pre-eclampsia in high-risk populations using angiogenic markers, such as serum placental growth factor (PlGF) assessment, has been shown to improve maternal outcomes and is recommended by the National Institute for Health and Care Excellence (NICE). However, such tests are not yet available at the point of care (POC). Glycosylated fibronectin (GlyFn) level for the prediction of pre-eclampsia development is available as a POC test (Lumella) and has the potential to aid rapid clinical decision making. This study aimed to test the hypothesis that the sensitivity of the GlyFn test is not inferior to that of the current gold standard of soluble fms-like tyrosine kinase (sFlt)/PlGF-based laboratory testing for pre-eclampsia.

Methods and analysis
This is a multicentre prospective study. Women at risk for pre-eclampsia based on predefined clinical and/or obstetric risk factors will be invited to participate in the study. The recruitment target is 400 participants. Consenting participants will have paired samples for sFlt/PlGF together with POC GlyFn testing. Two follow-up visits are planned at 2 and 4 weeks after the initial recruitment where repeat testing with both tests will be performed. The clinical team will be blinded to the results of the GlyFn test but not that of the sFlt/PlGF test. Clinical care will be based on established protocols incorporating maternal/fetal evaluation and the results of sFlt/PlGF levels. Maternal and neonatal outcome data will be collected to compare the sensitivity and specificity of the tests, with the primary outcome being delivery for pre-eclampsia within 4 weeks.

Ethics and dissemination
Ethical approval has been obtained from the Health Research Authority and Health and Care Research Wales Ethics Committee. The results of this study will be published in peer-reviewed journals and presented at scientific conferences.

Trial registration number
ISRCTN13430018

Introduction
Only 30%–50% of people referred to clinics during community-based eye screening are able to access care in Botswana, India, Kenya and Nepal. The access rate is even lower for certain population groups. This platform trial aims to test multiple, iterative, low-risk public health interventions and simple service modifications with a series of individual randomised controlled trials (RCT) conducted in each country, with the aim of increasing the proportion of people attending.

Methods and analysis
We will set up a platform trial in each country to govern the running of a series of pragmatic, adaptive, embedded, parallel, multiarm, superiority RCTs to test a series of service modifications suggested by intended service users. The aim is to identify serial marginal gains that cumulatively result in large improvements to equity and access. The primary outcome will be the probability of accessing treatment among the population group with the worst access at baseline. We will calculate Bayesian posterior probabilities of clinic attendance in each arm every 72 hours. Each RCT will continually recruit participants until the following default stopping rules have been met: >95% probability that one arm is best; >95% probability that the difference between the best arm and the arms remaining in the trial is

This Teachable Moment describes a man in his 30s who presented with a right diabetic foot ulcer and hyperglycemia and was assumed to have type 2 diabetes and was subsequently diagnosed with latent autoimmune diabetes in adults.

This Viewpoint proposes applying a systematic curriculum for early management of traumatically injured patients as a framework for suicide risk screening after overdose.

This model-based study using population-level cancer mortality data evaluates the association of prevention, screening, and treatment interventions with cumulative number of cancer deaths averted from 1975 to 2020 for breast, cervical, colorectal, lung, and prostate cancers.