Stroke, Ahead of Print. Background: We aimed to investigate whether rescue stenting (RS) following failed mechanical thrombectomy (MT) for acute basilar artery occlusion (BAO) results in superior functional outcomes and enhanced safety compared to the natural history of failed mechanical thrombectomy (MT).Methods: This retrospective cohort study utilized data from the PC-SEARCH registry, encompassing eight high-volume centers in the United States and covering the period from 2015 to 2021. Patients with BAO who experienced failed MT (mTICI score of 0-2a after at least one attempt of clot retrieval) were categorized based on whether they received additional intervention with RS. The primary outcome was a shift analysis of the 90-day mRS. Multivariable logistic regression was employed to assess both efficacy and safety outcomes.Results: Of a total of 444 patients, 119 presented failed MT and were included in the analysis. The RS group comprised 65 (14.6%) patients, while the control group consisted of 54 (12.2%) patients. After adjusting, the RS group showed a favorable shift in the overall 90-day mRS distribution (acOR=4.56; 95% CI 1.67-12.45; p=0.003) and higher rates of 90-day 0-3 mRS (RS: 44.6% vs. control: 18.5%, aOR=7.57; 95% CI 1.91-30.12; p = 0.004) compared to the control group. RS also showed lower rates of 90-day mortality (RS: 43.1% vs. control: 64.8%, aOR=0.27; 95% CI 0.09-0.80; p=0.018) and comparable rates of sICH (RS: 3.1% vs. control: 13%, aOR=0.31; 95% CI 0.05-1.95; p=0.214).Conclusions: Our study demonstrated that RS is associated with improved functional outcomes and reduced mortality in BAO patients presenting MT failure. Further randomized trials are needed to validate these findings.
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Cost-effectiveness of robotic surgery compared to conventional laparoscopy for the management of early-stage cervical cancer: a model-based economic evaluation in China
Objectives
The aim of this study is to assess cost-effectiveness of robotic radical hysterectomy (RRH) vs laparoscopic radical hysterectomy (LRH) in early-stage cervical cancer (ECC).
Design
Model-based cost-effectiveness analysis.
Setting
Based on long-term survival data, a three-state Markov model was constructed using TreeAge Pro 2022 to simulate the possible recurrence of ECC. Data on clinical efficacy and costs were derived from published literature and local databases.
Participants
A hypothetical cohort of 1000 individuals diagnosed with early-stage cervical cancer (FIGO 2009 stages
Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort study
Objectives
This study aims to evaluate and compare health outcomes and costs between home hospitalisation and traditional hospitalisation for three common diagnoses—cellulitis, urinary tract infection (UTI) and pneumonia.
Design
A retrospective cohort study.
Setting
Primary care, nationwide.
Participants
1311 patients in home hospitalisation and 992 in traditional hospitalisation.
Interventions
The primary intervention is home hospitalisation, compared with traditional hospitalisation. The intervention was performed according to medical considerations by a specialised team, and this study was done retrospectively to evaluate it.
Primary and secondary outcome measures
Primary measures included healthcare costs, length of hospitalisation, referrals for further medical services and mortality.
Results
Costs of home hospitalisation were lower compared with traditional hospitalisation (6056 vs 9619 NIS for pneumonia, 6011 vs 9767 NIS for cellulitis, 6466 vs 8552 NIS for UTI and p value
Gender differences in burnout among US nurse leaders during COVID-19 pandemic: an online cross-sectional survey study
Objectives
Among nurse leaders, gender should receive particular attention, because life and work experiences and burnout during COVID-19 pandemic may vary between women and men, potentially requiring different strategies to achieve well-being. Thus, information about gender differences in burnout might be critical to burnout prevention in nurse leaders. Additionally, there has been a substantial call for attention to gender during the COVID-19 pandemic, reflecting a concern that responses to the pandemic that fail to consider gender differences and norms will be ineffective. Therefore, the objective of the current study is to examine personal burnout, client burnout and work-related burnout of nurse leaders while considering the impact of COVID-19 pandemic and work-life balance through a gender lens.
Design
A cross-sectional study design was implemented in 2023 using a convenience sampling approach.
Setting
Data on personal burnout, work-related burnout, client burnout, work-life balance and COVID-19 impact were collected electronically and assessed through a gender lens.
Participants
A sample of 210 nurse leaders filled out the online surveys that were posted on the American Organization for Nursing Leadership and on Facebook.
Conclusion
Females had significantly higher personal burnout than males (mean 56.2 vs 49.3, F=5.853, p=0.019). Males had significantly higher client-related burnout than females (mean 45.3 vs 34.8, F=7.014, p=0.008). Findings demonstrate the importance of addressing gender when examining how nurse leaders react to different factors leading to burnout. In employing a gender lens framework, future researchers might study how the pressures that working men and women nurse leaders face were intensified during the COVID-19 pandemic. To support nurse leaders in executing their roles, there is a need to widen the scope of conversations about including family-friendly policies and attention to the needs of men and women as nurse leaders. These policies might include but are not limited to paid childcare, flexible time off, access to paid time off and mandatory overtime laws.
Screening for Helicobacter pylori to Prevent Gastric Cancer
This randomized clinical trial evaluates the effects of Helicobacter pylori stool antigen assessment plus fecal immunochemical testing (FIT), vs FIT alone, on gastric cancer incidence and mortality among adults in Taiwan.
Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury
This randomized clinical trial assesses the effect of a liberal vs a restrictive hemoglobin threshold for red blood cell transfusion on unfavorable neurological outcome in patients with acute brain injury.
Fecal Immunochemical Test vs Stool RNA Testing for Colorectal Cancer Screening—Reply
In Reply Our study adjusted the FIT cutoff to yield the same overall positivity rate as reported for the mt-sRNA test (17%) to enhance comparability of diagnostic performance of both tests. Below we address each of the 3 points made by Drs Yang and Ma.
Three vs 6 Cycles of Chemotherapy for High-Risk Retinoblastoma
This randomized clinical trial examines whether 3 cycles of carboplatin, etoposide, and vincristine chemotherapy is noninferior to 6 cycles for enucleated unilateral retinoblastoma with high-risk pathological features.
Fecal Immunochemical Test vs Stool RNA Testing for Colorectal Cancer Screening
To the Editor We read with interest the recent study that compared the fecal immunochemical test (FIT) positivity threshold vs multitarget stool RNA (mt-sRNA) testing for colorectal cancer screening. However, we have concerns regarding the study methodology and the capability of FIT to fully replace the mt-sRNA panel.
Pain during prolonged sitting in subjects with patellofemoral pain in Dutch physical therapy clinics: an online questionnaire-based analysis
Objectives
This study aimed to describe (1) differences between subjects with patellofemoral pain (PFP) with and without pain during prolonged sitting (PDPS), (2) minimum knee flexion angle and time to onset/disappearance of PDPS and (3) differences between those with PDPS at smaller/greater flexion angles and with fast/slow onset and disappearance of PDPS.
Design
Patient-reported online questionnaire.
Setting
Private physical therapy clinics in the Netherlands between May 2021 and March 2023.
Participants
87 participants (61 (70%) females, mean age 22.0 years (IQR 4.0), body mass index 23.1 (4.7)).
Outcome measures
Visual Analogue Scale for worst pain (VAS-W) and sitting pain (VAS-W sitting), the Anterior Knee Pain Scale (AKPS), knee flexion angle to provoke PDPS and time to onset/disappearance of PDPS.
Results
63 of 87 (72%) participants reported PDPS. Participants with PDPS experienced bilateral symptoms of PFP more frequently (71% vs 46%, p=0.44) and scored 12 points lower on the AKPS (p
Exploring paruresis ('shy bladder syndrome) and factors that may contribute to it: a cross-sectional UK survey study
Objectives
To assess the prevalence and severity of paruresis (‘shy bladder syndrome’) in a population of university staff and students and to determine if there was any relationship between demographics, self-esteem, presence of social anxiety disorders and negative toilet experiences and paruresis.
Design
We undertook an anonymised cross-sectional online survey using Microsoft Forms. We invited participants aged 18 and over to complete the survey which included demographic information; any pre-existing medically or self-diagnosed anxiety-related conditions; Shy Bladder Scale (SBS); Rosenberg Self-Esteem Scale (RSES) and questions about using school toilets in their younger life. We defined ‘mild’ and ‘severe’ paruresis based on total SBS cut-off scores of greater than or equal to 31 and greater than or equal to 40. We calculated prevalence of paruresis, and explored differences in self-esteem, school toilet experience and social anxiety disorders between individuals with and without paruresis. Multivariable logistic regression was used to determine which variables had any influence on having a ‘mild’ and ‘severe’ paruresis diagnosis.
Setting
We distributed the survey to all staff and students via their university email address as well as promoting the survey on university social media sites.
Results
We received responses from 356 individuals. Most participants (237, 66.6%) were within the 18–30 year age category and most (277, 77.8%) were white. There were 221 (62.1%) females, 119 (33.4%) males and 16 (4.5%) other genders. The prevalence of ‘mild’ paruresis was 25.8% and of ‘severe’ paruresis 14.9% in this sample. 73.0% indicated that they had at least one medically or self-diagnosed anxiety disorder. There was a statistically significant difference in the total SBS score between individuals with and without an existing anxiety disorder (8 vs 19,
Simultaneous vs. Sequential Administration of COVID-19 and Influenza Vaccines
This randomized trial showed no difference in local or systemic side effects in patients receiving their vaccines on either schedule.
Linee Guida per la prevenzione, diagnosi e gestione della BPCO
Questo rapporto del 2025 Global Initiative for Chronic Obstructive Lung […]
Intracytoplasmic sperm injection compared with in vitro fertilisation in patients with non-male factor infertility with low oocyte retrieval: a single-centre, retrospective cohort study
Objective
To investigate the effects of in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) on the clinical outcomes of non-male factor patients aged >35 with three or fewer oocytes retrieved.
Design
Retrospective cohort study.
Setting
Reproductive centre of a university-affiliated hospital in China.
Participants
547 women with non-male factor infertility who underwent assisted reproductive technology (ART) treatment with three or fewer oocytes retrieved were identified from June 2019 to May 2022. Of these 547 patients, 334 were treated with IVF and 213 with ICSI.
Outcome measures
The primary outcomes were normal fertilisation rate, live birth rate per transfer and cumulative live birth rate per retrieval.
Results
The baseline characteristics were comparable between the two groups, except for the proportion of primary infertility, which was higher in the ICSI group (17.66% vs 32.86%, p=0.000). Compared with the IVF group, the ICSI group showed higher normal fertilisation rate and lower cycle cancellation rate (65.99% vs 76.56%, p=0.002; 33.53% vs 24.41%, p=0.023). However, no significant differences were found in clinical pregnancy rate per transfer (23.86% vs 18.92%, p=0.545), miscarriage rate per fresh embryo transfer (19.05% vs 28.57%, p=0.595), live birth rate per transfer (17.05% vs 13.51%, p=0.623), cumulative clinical pregnancy rate per retrieval (12.87% vs 11.27%, p=0.576) and cumulative live birth rate per retrieval (9.28% vs 6.57%, p=0.261) between the two groups (p >0.05).
Conclusions
In non-male factor ART cycles, ICSI was not associated with improved pregnancy outcomes in older women with a low number of oocytes retrieved. Routine use of ICSI is not recommended in older women who are infertile due to non-male factors.
Primary prevention of cardiovascular diseases among women in a South Asian population: a descriptive study of modifiable risk factors
Objective
The aim of this study was the assessment of modifiable risk factors of cardiovascular diseases (CVD) among women versus men at a newly developed preventive cardiology clinic of a large tertiary care cardiac centre in Pakistan.
Design
Observational study.
Setting
Tertiary care cardiac hospital in Karachi, Pakistan.
Participants
Data for this study were obtained retrospectively from a prospectively collected ongoing registry. We have included all female and male individuals who have presented or were referred to our clinic for primary prevention. All the participants had no history of ischaemic heart disease.
Outcome measure
In this study, we evaluated the CVD risk factors, estimated risk of CVD, and glycaemic and cholesterol control at baseline and at subsequent follow-ups for high-risk patients.
Results
A total of 535 patients, 314 females, were included with a mean age of 48.3±12.5 years. At baseline, 57.9% (128) of men versus 73.2% (230) of women (p
Diabete, le nuove tecnologie rivoluzionano la gestione: sensori, microinfusori e pancreas artificiali
I moderni dispositivi permettono di adattare la terapia insulinica alle esigenze individuali di ciascun paziente, migliorando l’efficacia del trattamento