Search Results for: Terapia antibiotica: breve durata vs. lunga durata

Objectives
Telehealth, the provision of healthcare through digital communication, has been proposed as a potential solution to meet the increasing demand for healthcare, particularly in the setting of the COVID-19 pandemic. Sweden has an established national telehealth service for triage and referral by phone (1177) since 2013 which has the potential to meet this increasing demand. However, little is known about the development and retention in demand during and after the pandemic in Sweden. The objective of this study was to investigate the utilisation of the national telehealth service in Sweden before, during and after the pandemic in relation to emergency department (ED) visits.

Methods
This was a retrospective observational study of telephone calls to the national telehealth service in Sweden. We collected the number of calls, number of answered calls and visits to ED in Sweden from 2017 through 2021, aggregated by month. The difference in number of calls and visits was analysed using Student’s t-test for related samples.

Results
Data were collected from all 21 healthcare regions in Sweden, serving 10.5 million citizens. The average number of monthly calls was 48 (SD 10) calls per 1000 citizens. The first month of the pandemic, March 2020, had the highest monthly calls per capita during the whole study period: 62 (diff 14, 95% CI 9 to 19, p

Da biopsia liquida a studio cellule epatiche, per malattie rare

Efficace nel 30% dei pazienti che non risponde alle altre cure

Objectives
To describe outcomes in women admitted for labour care to midwifery units with gestational or pre-existing diabetes, compare outcomes with other women admitted to the same units and describe admission and care guidance in midwifery units typically admitting women with diabetes.

Design
A national cohort study and a survey of practice.

Setting
We used the UK Midwifery Study System to collect data from midwifery units in the UK between October 2021 and February 2023.

Participants
Women with a diagnosis of diabetes admitted for labour care to a midwifery unit were compared with a cohort of women without diabetes admitted for labour care to the same units.

Primary and secondary outcome measures
The primary outcome was a composite measure of maternal outcome reflecting the need for obstetric care (one or more of augmentation, instrumental birth, caesarean birth, maternal blood transfusion, third or fourth-degree perineal tear, maternal admission to higher level care). We also investigated a number of secondary maternal and neonatal outcomes.

Results
Overall, 420 (0.7% (95% CI 0.67% to 0.82%) of the 56 648 women admitted to midwifery units in the study period were recorded as having diabetes, most (84%) with diet-controlled gestational diabetes. Women with diabetes were no more likely than comparison women to experience the composite primary outcome (18.7% vs 20.7%, adjusted relative risk=1.31, 95% CI 0.96 to 1.80). We found no statistically significant differences between the two groups for the secondary maternal and neonatal outcomes investigated: augmentation, postpartum haemorrhage >1.5 L, shoulder dystocia, maternal blood transfusion and maternal admission for higher level care, Apgar

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

This randomized clinical trial compares the effects of screening frequency (once-daily vs more frequent screening) and spontaneous breathing trial techniques (pressure-supported vs T-piece spontaneous breathing trial) on the time to successful extubation among critically ill adults who required invasive mechanical ventilation.

In Reply In response to specific points raised by Drs Yang and Tebbutt, kidney donors in our study received in-center hemodialysis during their hospitalization at the time of donation. Warm ischemic time was calculated as the number of minutes from withdrawal to cross-clamp time in donors after cardiac death. The donors after cardiac death who had undergone dialysis (n = 35) had similar warm ischemic time (median, 28 minutes [IQR, 22.5-34.0 minutes]) vs the 35 donors after cardiac death who had not undergone dialysis (median, 27 minutes [IQR, 21.0-31.0 minutes]) (standardized mean difference, 0.08).

This population-based retrospective cohort study uses linked health administrative databases to assess the risk of treatment discontinuation and mortality among adults in British Columbia, Canada, receiving buprenorphine/naloxone vs methadone for the treatment of opioid use disorder.

In Reply We thank Kang and Wu for the questions they raised. Our study reported on long-term follow-up, nearly 10 years after the first patient was randomized to a 6-month lay health worker–led advance care planning education and engagement intervention layered onto usual cancer care (intervention group) vs usual cancer care alone (control group). All patients randomized to the intervention group received the intervention for a duration of 6 months or until death, whichever was first, by 1 lay health worker with a Bachelors of Arts degree. The results report on the sustained associated benefit of the intervention on several key outcomes nearly 10 years after the intervention was completed for the participants. We agree that more evidence is needed regarding the scalability of such an intervention. Hence, our team has several ongoing multisite trials to evaluate whether the intervention is effective on these key outcomes at scale.

In Reply We thank Kikuchi and colleagues for their interest in our article in this issue of JAMA Psychiatry and welcome the opportunity to address their comments. In our article, we report relatively high pneumonia risks during the use of antipsychotics with high anticholinergic burden prescribed in high doses. Antipsychotics prescribed in monotherapy were associated with pneumonia risk, whereas polytherapy (≥2 antipsychotics used simultaneously) was not.

In Reply We appreciate the Letter to the Editor from Farber regarding our randomized clinical trial on the effectiveness of electronic cigarettes in smoking cessation. Data presentation plays an important role in medical publications. Guidelines such as the Consolidated Standards of Reporting Trials (CONSORT) reporting guideline with its extensions provide a useful framework for presenting the main findings of a randomized clinical trial. We have adhered to these guidelines. For clinical trials published in JAMA Internal Medicine, study results must be reported consistently with what was prespecified in their trial design, as documented in the trial registration, protocol, and statistical analysis plan. In our article, the prespecified primary outcome (confirmed 7-day combustible cigarette smoking abstinence on week 26) took priority and precedence over all other data presentations.

This Viewpoint describes allowing for hospital staff discretion regarding strict adherence to policy vs best interest of the patient.

This cohort study examines 20 years of data for Danish patients who had electroconvulsive therapy (ECT) to compare the risk of hospitalization or suicidal behavior between patients who had continuing and maintenance ECT vs acute ECT alone.