Search Results for: Analisi sull’uso dei farmaci anti-osteoporotici in sette database europei

Background
Studies examining the association between Medicaid expansion (ME) under the Affordable Care Act (ACA) and colon cancer incidence have produced mixed results.

Objective
To re-visit the association between the ACA-ME and annual cases of colon cancer.

Design
Difference-in-differences (DiD).

Setting
The primary analyses used data from the National Cancer Database from 2010 to 2018, a hospital-based cancer registry in the USA. We also conducted exploratory analyses using data from the Surveillance, Epidemiology and End Results (SEER) registry.

Patients
Patients aged 40 and older with newly diagnosed colon cancer.

Measurements
The primary outcome was the percent change in colon cancer of all stages. Secondary outcomes were percent changes in stage I and stage IV cases.

Results
Among those aged 40–49, we observed a statistically significant greater increase in stage I colon cancer in expansion states relative to non-expansion states (DiD (percent change) 9.7% (95% CI, 2.5% to 17.4%)). In those aged 50–64, we did not observe statistically significant differences between the two state groups in any of the outcomes. Among those aged 65+, we observed a statistically significant relative decrease for all stages in ACA-ME states (–1.0% (95% CI, –1.0% to –3.0%)) and for stage IV (–3.0% (95% CI, –2.0% to –5.0%)). We explored our findings among younger individuals (

Introduction
Videolaryngoscopes are recommended as the top preference for tracheal intubation in adults, children, infants and neonates, and even in patients with anticipated difficult airways, since they are generally easier to use and quicker to master than fibreoptic bronchoscopes. Compared with standard videolaryngoscopes, hyperangulated videolaryngoscopes possess a more sharply curved blade or blade tip, resulting in a higher first-attempt success rate among patients with anticipated difficult airways. However, hyperangulated videolaryngoscopes also pose challenges in advancing the tracheal tube, which decreases the first-attempt success rate while increasing the tracheal intubation time when the tracheal tube introducer is unsuitable. Hence, controversy still remains regarding the efficiency of hyperangulated videolaryngoscopes as first-line devices in patients with anticipated difficult airways, owing to the inconsistent clinical findings. Consequently, we will conduct a protocol for a systematic review and meta-analysis to determine the usefulness of hyperangulated videolaryngoscopes in patients with anticipated difficult airways.

Methods and analysis
English-language databases (Web of Science, Cochrane Library, PubMed, Embase and Ovid Medline), Chinese electronic databases (VIP database, China National Knowledge Infrastructure, and Wanfang database) and clinical trial registry platforms will be scoured from their inception to May 2025 to locate randomised controlled trials of hyperangulated videolaryngoscopes in patients with anticipated difficult airways. For continuous data, mean differences or standardised mean differences, accompanied by their 95% CIs, and for dichotomous data, the risk ratio, accompanied by its 95% CI, will be calculated using Review Manager V.5.4. Either a fixed-effects model or a random-effects model will be used depending on the magnitude of statistical heterogeneity as evaluated via the I2 test. The risk of bias will be assessed via the Cochrane risk-of-bias tool 2. Additionally, the quality of evidence regarding each outcome will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation. The reliability of all outcomes will be appraised via trial sequential analysis. Moreover, the publication bias of all outcomes will be examined using Funnel plots and Egger’s regression test.

Ethics and dissemination
Ethical approval was not required for this systematic review protocol. The results will be disseminated through peer-reviewed publications.

PROSPERO registration number
CRD42024627484

Le segnalazioni con almeno un evento grave associato ai vaccini anti-Covid-19 sono state 572 nel 2023, pari al 46,7% delle segnalazioni totali su questi vaccini. Lo rileva il rapporto 2023…

Objective
To evaluate the prognostic ability of the haemoglobin-to-red blood cell distribution width ratio in predicting in-hospital mortality among elderly patients diagnosed with acute ischaemic stroke.

Design
Retrospective, longitudinal, observational study using a hospital-based database.

Setting
Claims data from 1 January 2014 until 31 January 2020 were extracted from the database of two hospitals affiliated with Nanjing University.

Participants
Patients aged ≥80 years who were diagnosed with acute ischaemic stroke, excluding those with cancers or other malignant diseases.

Outcome measures
Patients were stratified into three groups based on the tertiles of the haemoglobin-to-red blood cell distribution width ratio. The dose-dependent relationship between this ratio and in-hospital mortality risk was determined with robust locally weighted regression analyses and restrictive cubic spline on continuous variables. The primary endpoint was defined as all-cause mortality during the hospital stay, and the secondary endpoint centred on the duration of the hospital stay.

Results
A total of 606 patients constituted the dataset for the conclusive analysis (mean age, 84.6 ± 3.2 years; female, 40.3%). The haemoglobin-to-red blood cell distribution width ratio was categorised into three tertiles (T1, 8.34). After adjusting for relevant demographic and clinical variables, a statistically significant inverse correlation was observed between higher ratios and lower risk of in-hospital mortality, with HRs of 0.48 (95% CI, 0.34 to 0.68) for T2:T1 and 0.14 (95% CI, 0.08 to 0.23) for T3:T1. A dose-dependent relationship was evident between the haemoglobin-to-red blood cell distribution width ratio and in-hospital mortality risk. The sensitivity analysis indicated that no attenuation was observed in the HR in both non-anaemic and anaemic cases. The results also indicated that a shorter length of hospital stay was associated with a higher haemoglobin-to-red blood cell distribution width ratio.

Conclusions
A high haemoglobin-to-red blood cell distribution ratio may be an independent protective factor for in-hospital mortality and reduced length of stay in elderly patients suffering from acute ischaemic stroke.

Objectives
To evaluate changes in oral corticosteroid (OCS) use after the publication of the 2014 Japanese clinical practice guidelines for myasthenia gravis (MG).

Design
Retrospective cohort study performed in three Japanese health insurance databases: the JMDC database between 2005 and 2021; the DeSC database covering the National Health Insurance (NHI) and the DeSC database covering the Late-Stage Elderly Healthcare Service (LSEHS) between 2014 and 2021. Achievement of OCS ≤5 mg/day was defined as ≥90 days of consecutive OCS ≤5 mg/day during follow-up, without any gap longer than 60 days between two consecutive claims. The time to achieve OCS ≤5 mg/day was estimated using Kaplan-Meier survival analysis.

Setting
Real-world treatment setting in Japan.

Participants
Patients aged ≥16 years with a record of MG (International Classification of Diseases 10th edition code: G70.0) with a serological test, who had baseline period ≥180 days before inclusion with no MG claim and who started immunotherapy (including OCS) within 90 days of MG diagnosis.

Outcome measures
Prescription of OCS and other therapies for MG.

Results
Overall, 811 patients were included. The mean age was 49 years in the JMDC, 61 years in the NHI and 80 years in the LSEHS. In the JMDC, the median time to achieve OCS ≤5 mg/day was significantly shorter (p=0.042; log-rank test) in patients included in 2015 or later (11.0 months) than in patients included before 2015 (17.9 months). The median time to achieve OCS ≤5 mg/day was shorter in the LSEHS (6.5 months) than in the JMDC (11.0 months) and the NHI (11.7 months).

Conclusions
Faster tapering of the OCS dose was observed in patients starting treatment after the publication of the 2014 guidelines, although use of higher-dose OCS remained widespread after this date. This highlights the need to improve awareness of guidelines by healthcare providers in order to decrease the burden of higher-dose OCS.

Trial registration number
Clinical Trials Registry (UMIN-CTR): UMIN000051155; Post-results.

Introduction
Randomised controlled trials (RCTs) are considered the gold standard for evaluating the efficacy and safety of healthcare interventions. For valid systematic reviews and evidence-based clinical guidelines, it is essential that results of all eligible RCTs are accessible. However, articles about trials published in languages other than English are often not listed in well-known and open trial databases like Medline and therefore scarcely findable. Handsearching national journals is an important approach to identify these articles and enhance their global visibility. Consequently, the results of trials conducted and published in non-English-speaking countries are not lost but rather integrated into the global body of evidence.
The present study aims to evaluate the benefits of extensive handsearching in Hungary and to identify key medical fields for future efforts. We will also assess the extent of grey literature in Hungary. We will appraise the risk of bias in the identified RCTs and controlled clinical trials (CCTs; indicating quasi-randomised or possibly randomised controlled trials) and examine the reporting quality of articles in Hungarian medical journals. Additionally, we will explore whether the automation tool Paperfetcher, recommended by Cochrane for handsearching, can effectively support these efforts in a non-English language context.

Methods and analysis
We will conduct a cover-to-cover handsearch of all Hungarian medical journals publishing content in the year 2023 to identify all controlled clinical trials, including RCTs, CCTs and non-RCTs, which are trials that use a clearly non-random method for allocating participants to groups. We will also search conference proceedings submitted to the Hungarian National Széchényi Library, abstract supplements from journals available via the Hungarian Medical Bibliography database, preprints available on medRxiv, Hungarian theses and dissertations, as well as Google Scholar to identify grey literature.
Two independent researchers will screen the identified records, assess their eligibility, extract data and evaluate the risk of bias and reporting quality according to the CONSORT statement. To verify the availability of reports and publications derived from the identified trials in electronic databases, we will systematically search MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase and Scopus. All identified RCTs and CCTs not yet included in CENTRAL will be added to the database. Additionally, we will compare handsearching supported by the Paperfetcher tool with unsupported handsearching to evaluate the tool’s effectiveness in a Hungarian language context.

Ethics and dissemination
Since the publication resulting from the handsearching activity is a retrospective review of publicly available sources of evidence, ethical approval is not required. The study findings will be submitted for publication in a peer-reviewed journal and will be presented at international conferences.

Introduction
Career plateau is a situation that has many negative effects on individual nurses, nursing management and nursing profession. Despite global research examining career plateaus among nurses, a comprehensive data synthesis on its prevalence and influential factors is still missing. The study aims to systematically analyse the prevalence of career plateau in nurses and explore the related influencing factors.

Methods and analysis
The anticipated start date for the study is December 2025, and the anticipated end date is August 2027. We will search PubMed, Web of Science, Embase, PsycINFO, CINAHL, Scopus, the China National Knowledge Infrastructure, the Wanfang database and the China Biomedical Literature Database (SinoMed) from the establishment of the database to the present for studies on the prevalence and influencing factors of career plateau in nurses. Two researchers will independently conduct literature screening and data extraction. They will evaluate the quality of the included studies using the Joanna Briggs Institute critical appraisal tool and the mixed-methods appraisal tool. If possible, we will conduct a meta-analysis, which is according to the data heterogeneity. If the heterogeneity is too large to be resolved, we will present them narratively and descriptively according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, summarise status and influencing factors of the career plateau in nurses.

Ethics and dissemination
No formal ethics approval is required for this protocol and no primary data will be collected. The results will be disseminated through peer-reviewed journals and presented at conferences.

PROSPERO registration number
CRD42024545439.

Objectives
Despite palliative care (PC) potentially improving quality of life, only a tiny proportion of patients with heart failure (HF) are receiving PC. Globally, PC for HF patients faces several challenges; however, a systematic assessment of the barriers and facilitators to PC of patients suffering from HF is lacking. We aimed to identify barriers and facilitators to offering PC to HF patients.

Design
The mixed-methods systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.

Data sources
PubMed, CINAHL, MEDLINE, PsycINFO, Web of Science were searched from onset of literature database to 24 March 2025.

Eligibility criteria
We included both qualitative studies and quantitative studies addressing barriers and facilitators to offering PC to patients with HF reported by healthcare providers, patients, family members and caregivers.

Data extraction and synthesis
Data extraction was done independently by two reviewers, and quality assessment was completed using the mixed-methods appraisal tool. The Capabilities-Opportunities-Motivations-Behaviour (COM-B) model and the Theoretical Domain Framework (TDF) were used to identify potential barriers and facilitators.

Results
48 studies were included out of 4168. 289 items related to barriers and 88 items related to facilitators were categorised into 72 themes. These themes were found to align with at least one of the 14 TDF domains and the COM-B model. ‘Environmental context and resources’ (eg, lack of time, human, facilities and equipment resources; 77.2% of barriers vs 22.8% of facilitators), ‘knowledge’ (eg, insufficient awareness and knowledge of PC and/or needs; 91.8% of barriers vs 8.2% of facilitators) and “‘social influences’ (eg, limited communication and collaboration between healthcare professionals; 58.7% of barriers vs 41.3% of facilitators) were the three TDF domains that encoded the largest amount of data.

Conclusions
This review identified key barriers to PC for HF patients, primarily involving resource limitations, knowledge gaps and poor interdisciplinary collaboration. Findings highlight the need for targeted interventions addressing systemic and knowledge-related challenges.

PROSPERO registration number
CRD42023484807.

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Objective
We aimed to estimate prevalence and identify determinants of hypertension in adults aged 15–49 years in Tanzania.

Design
We analysed cross-sectional survey data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey conducted between February and July 2022. Descriptive statistical analysis, logistic regression, machine learning and geospatial methods were used to estimate prevalence and determine determinants of hypertension.

Setting
Tanzania.

Participants
A total of 13 385 participants aged 15–49 years were included in the analysis.

Primary outcome
The primary outcome variable was hypertension, defined as either systolic blood pressure (BP)≥140 and/or diastolic BP≥90 mm Hg or under anti-hypertensive drugs.

Results
The prevalence of hypertension among adults of reproductive age was 11% (95% CIs 10.09 to 11.56) in Tanzania, varying significantly across risk factors. Prevalence was high in people aged 40–49 (22.11%, 95% CI 20.07 to 24.29) and obese (23.69%, 95% CI 20.67 to 27.00). The mean prevalence of hypertension was also high in the southern, eastern, western, southern highlands, north-west and north-eastern part of the country, correlating with the spatial distribution of older age (30–49) and higher body mass index (BMI) (≥25). Individuals aged 40–49 had nearly six times (adjusted OR (AOR): 5.68, 95% CI 4.10 to 7.83) the odds of hypertension relative to those aged 15–19. Obese individuals had higher odds (AOR: 2.88, 95% CI 2.01 to 4.13) compared with overweight individuals (AOR: 1.93, 95% CI 1.36 to 2.74). Machine learning results showed age and BMI as the most important determinants of hypertension and that significant interactions between risk factors exist.

Conclusion
The prevalence of hypertension varied across risk factors and the strongest determinants of hypertension in adults of reproductive age were age and BMI.

Objectives
Inflammatory bowel diseases (IBDs) and multiple sclerosis (MS) are inflammatory diseases resulting from an interplay of genetic and environmental factors. This study aims to describe the prevalence of patients diagnosed with both conditions among those receiving hospital care in England, as well as the characteristics and healthcare resource use (HCRU) of such patients.

Design
This study is a retrospective observational cohort study.

Setting
The study was conducted through secondary use of the English Hospital Episode Statistics (HES) Database. HES records care delivered by hospitals in England and associated diagnoses.

Participants
Patients who had a diagnosis code for either IBD or MS recorded in HES between January 2014 and May 2020 were included. Patients were classified as having each diagnosis individually or as having both diagnoses, in which case they were further categorised based on temporal occurrence.

Primary and secondary outcome measures
The primary outcome was the prevalence of patients with a recorded diagnosis of either IBD, MS or both during the study period. Secondary outcome measures included patient demographic and clinical characteristics, as well as HCRU in the 6 months before and after the diagnosis of interest.

Results
From an overall cohort of 352 698 patients, 1016 (0.3%) had both diagnoses. Among those with both, 29.8% (303) had a record of IBD first, 40.5% (411) had MS diagnosed first and 29.7% (302) had the first record of both diagnoses in the same episode. From the overall cohort, 80.9% (285 439) of patients had a single diagnosis of IBD, and 18.8% (66 243) of patients had a single diagnosis of MS.

Conclusions
The population with a dual diagnosis of IBD and MS is larger than previously reported and shows evidence of frequent interactions with secondary care.

Introduction
Pre-eclampsia is a harmful and potentially life-threatening condition affecting maternal health and fetal well-being. In response to the need for timely and continuous monitoring, remote health technologies have been implemented for blood pressure control among this group over the last decades. The purpose of this study is to synthesise qualitative evidence on the experiences of adopting remote technologies for blood pressure control among women with pre-eclampsia and their healthcare providers.

Methods
Peer-reviewed publications published in English from January 2013 to March 2023 were searched using seven electronic databases: PubMed, Nursing & Allied Health Premium (ProQuest), Scopus, ScienceDirect, Taylor & Francis Online, Google Scholar and EBSCO Open Dissertations. The findings were subjected to meta-synthesis using the Joanna Briggs Institute meta-aggregation approach, whereby credible and unequivocal findings supported by participant quotations were extracted, grouped into categories and then integrated into synthesised findings through consensus among reviewers. A total of 4827 studies were identified in the initial database search. Twelve eligible studies were included in the meta-synthesis.

Results
Among 12 studies, five synthesised findings were elicited from women’s experiences with remote monitoring, including reassurance and increased self-confidence in health, a sense of autonomy, enhanced awareness of their health, acceptability and satisfaction with telehealth and reduced anxiety and stress. Providers’ perspectives on telehealth were presented in four synthesised findings: increasing value for oneself and work, strengthening knowledge and skills on pre-eclampsia, improving quality of care and concerns about technology challenges.

Conclusion
Healthcare providers reported professional growth and improved care delivery, though technical challenges persist. These findings support the integration of remote monitoring into maternal healthcare.

Introduction
Research on therapeutic mobility is abundant but the field of cancer has not yet been investigated thoroughly. This scoping review aims to examine the existing evidence on global therapeutic mobility and cancer, providing a comprehensive overview of the subject.

Methods
We conducted a scoping review and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodological guidelines. We developed a comprehensive search strategy and discussed it with the research team. We searched for peer-reviewed papers on Medline, Embase, ERIC and American Psychological Association via the Dialogue interface and Google Scholar and CAIRN bibliographic database for peer-reviewed articles. We also included grey literature, such as unpublished work and relevant reports from Érudit. We considered studies that employed quantitative or qualitative methods.

Results
Among the 1615 references initially selected, 767 duplicates were excluded. Then, 849 studies were screened on title and abstract and 800 were excluded as they did not meet inclusion criteria. 49 studies were fully screened and 21 were excluded as they did not meet inclusion criteria based on full-text assessment. Ultimately, 28 references were included in the data synthesis. This scoping review has shown that publications on therapeutic mobilities have multiplied in recent years, with a turning point in 2019. A range of academic disciplines and research methodologies are currently employed to describe them. A significant proportion of fieldwork is concentrated in Asia, Africa, Europe and North America. Despite the heterogeneity of the approaches and fields, there are certain common features that emerge: first, the decision to migrate for healthcare is primarily made by the patient themselves and is perceived by them as being non-choice; second, the family plays a central role at all stages of the migration; and third, the migration has a catastrophic impact in terms of social and financial burden.

Conclusion
In conclusion, this scoping review highlights the underexplored relationship between global therapeutic mobility and cancer, emphasising the need for increased research efforts to understand the global dynamics of cancer care mobility.

Objectives
To examine the association between cigarette price increase and youth smoking initiation in Bosnia and Herzegovina (B&H), and to assess additional factors—including parental smoking, peer influence, pocket money, anti-tobacco media exposure and smoking in school environments—that potentially affect smoking initiation among adolescents.

Design
A pseudopanel study using WHO Global Youth Tobacco Survey (GYTS) data from two compatible surveys conducted in 2018 (Republic of Srpska) and 2019 (Federation of B&H). A split-population duration model was employed to estimate the hazard of youth smoking initiation.

Setting
Primary and secondary schools across two entities in B&H, covering both urban and rural areas.

Participants
A total of 9702 students aged 13–15 years completed the surveys. Inclusion criteria involved being enrolled in grades 7–9 of primary school or the first year of secondary school. No additional exclusion criteria were applied beyond incomplete or invalid survey responses.

Interventions
None.

Primary outcome measure
Self-reported smoking initiation, defined as having tried or experimented with cigarette smoking, even one or two puffs.

Results
A 10% increase in cigarette prices was associated with a 4.9% reduction in the probability of youth smoking initiation (price elasticity of –0.491, p

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