Risultati per: Diagnosi e gestione dell’aneurisma aorta addominale (AAA)

In older patients with asymptomatic abdominal aortic aneurysms, outcomes were slightly better with local anesthesia.

Con la Radiomica si può sapere se il paziente risponde a terapie

Denunciato: medico e infermiera presi a calci dopo il soccorso

Per tumori in stadio 1 per la guarigione basta un anno. Favo, possibili tempi più brevi per l’oblio oncologico

Introduction
Incisional hernia (IH) is a prevalent and potentially dangerous complication of abdominal surgery, especially in high-risk groups. Mesh reinforcement of the abdominal wall has been studied as a potential intervention to prevent IHs. Randomised controlled trials (RCTs) have demonstrated that prophylactic mesh reinforcement after abdominal surgery, in general, is effective and safe. In patients with abdominal aortic aneurysm (AAA), prophylactic mesh reinforcement after open repair has not yet been recommended in official guidelines, because of relatively small sample sizes in individual trials. Furthermore, the identification of subgroups that benefit most from prophylactic mesh placement requires larger patient numbers. Our primary aim is to evaluate the efficacy and effectiveness of the use of a prophylactic mesh after open AAA surgery to prevent IH by performing an individual patient data meta-analysis (IPDMA). Secondary aims include the evaluation of postoperative complications, pain and quality of life, and the identification of potential subgroups that benefit most from prophylactic mesh reinforcement.

Methods and analysis
We will conduct a systematic review to identify RCTs that study prophylactic mesh placement after open AAA surgery. Cochrane Central Register of Controlled Trials, MEDLINE Ovid, Embase, Web of Science Core Collection and Google Scholar will be searched from the date of inception onwards. RCTs must directly compare primary sutured closure with mesh closure in adult patients who undergo open AAA surgery. Lead authors of eligible studies will be asked to share individual participant data (IPD). The risk of bias (ROB) for each included study will be assessed using the Cochrane ROB tool. An IPDMA will be performed to evaluate the efficacy, with the IH rate as the primary outcome. Any signs of heterogeneity will be evaluated by Forest plots. Time-to-event analyses are performed using Cox regression analysis to evaluate risk factors.

Ethics and dissemination
No new data will be collected in this study. We will adhere to institutional, national and international regulations regarding the secure and confidential sharing of IPD, addressing ethics as indicated. We will disseminate findings via international conferences, open-source publications in peer-reviewed journals and summaries posted online.

PROSPERO registration number
CRD42022347881.

Sarà sfruttata la sensoristica all’avanguardia insieme all’intelligenza artificiale.

‘Spesso sono forme lievi non diagnosticate in età infantile’

Aifa approva la rimborsabilità della nuova formulazione in compresse di un farmaco mirato

Gli oncologi, l’intervento tempestivo aiuta la cura. La chemioterapia probabilmente è preventiva per evitare le recidive

To the Editor We would like to highlight some concerns surrounding the study design and findings of the UK-REBOA randomized clinical trial that evaluated the effectiveness of REBOA and standard care compared with standard care alone.

To the Editor One of the key issues that came to our attention in the recent UK-REBOA study was the high proportion of patients randomized to the REBOA and standard care group who did not have an aortic balloon inserted. In 8 cases (17%), it was reported that clinicians were unable to establish access to the femoral artery.