Search Results for: Indicazioni per gli screening oncologici

Introduction
Physiotherapists provide non-pharmacological conservative treatment for osteoarthritis (OA) using a wide spectrum of interventions. Previous surveys have identified global physiotherapy OA management practices. However, no review to date summarises the scope and findings of these studies. This article describes a scoping review protocol to map the surveys investigating physiotherapeutic interventions offered to patients with OA to identify the treatment interventions currently used for OA, the physiotherapists’ attributes and organisational practice factors potentially associated with the choice of these interventions and to detect knowledge-practice gaps in the provision of physiotherapeutic interventions in OA treatment, contributing to guiding future research on this topic.

Methods and analysis
This is a protocol for a scoping review that will be based on Arksey and O’Malley scoping review methodology and the methodological guidance for conducting scoping reviews published by the Joanna Briggs Institute (JBI). Relevant articles will be searched using the following databases: Medline (PubMed), Embase, Web of Science and Google Scholar. Surveys studies addressing physiotherapeutic interventions offered to patients with OA will be included. Study will be selected through title/abstract and full-text screening stages and data will be extracted using an instrument based on the model available in the JBI Manual. The findings will be summarised using descriptive statistics according to our research questions. This review will be reported in accordance with the Preferred Items for Systematic Reviews and Meta-Analyses for Scoping Reviews.

Ethics and dissemination
Ethical approval is not required for this scoping review. Review findings will be disseminated through peer-reviewed publications, scientific conference presentations and scientific meetings.

Study registration
This protocol has been registered with the Open Science Framework (DOI 10.17605/OSF.IO/J3RBT).

Fino a oggi era fissata a 50 anni. Si parte nel 2025

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

In 2009, the first state dense breast legislation was passed in Connecticut, requiring that women who undergo mammography receive written notification of breast density. This advocacy-driven policy was intended to raise women’s awareness that dense breasts are a risk factor for breast cancer and can also obscure breast cancer on mammography. Since then, 37 states and the District of Colombia have followed with their own reporting laws, and beginning in September 2024, the US Food and Drug Administration will require breast density notification to be included in mammography reports for all patients and their referring clinicians.

This model-based comparative effectiveness analysis examines the long-term benefits and harms of digital breast tomosynthesis and supplemental breast magnetic resonance imaging screening by breast density using data on screening performance from the Breast Cancer Surveillance Consortium.

Ancora pochi screening. Consulenze gratuite sui treni a ottobre

Ancora pochi screening. Consulenze gratuite sui treni a ottobre

Use of MRI led to fewer biopsies and fewer diagnoses of clinically insignificant cancer.

In a large observational study, women with false-positive results were less likely to return for future screening.

Cardiologi, screening dai 18 anni per colesterolo e ipertensione

Objective
To assess the feasibility of identifying markers of health-seeking behaviour and healthcare access in UK electronic health records (EHR), for identifying populations at risk of poor health outcomes and adjusting for confounding in epidemiological studies.

Design
Cross-sectional observational study using the Clinical Practice Research Datalink Aurum prelinked to Hospital Episode Statistics.

Setting
Individual-level routine clinical data from 13 million patients across general practices (GPs) and secondary data in England.

Participants
Individuals aged ≥66 years on 1 September 2019.

Main outcome measures
We used the Theory of Planned Behaviour (TPB) model and the literature to iteratively develop criteria for markers selection. Based on this we selected 15 markers: those that represented uptake of public health interventions, markers of active healthcare access/use and markers of lack of access/underuse. We calculated the prevalence of each marker using relevant lookback periods prior to the index date (1 September 2019) and compared with national estimates. We assessed the correlation coefficients (phi) between markers with inferred hierarchical clustering.

Results
We included 1 991 284 individuals (mean age: 75.9 and 54.0% women). The prevalence of markers ranged from

Objective
This paper aims to evaluate the literature on the prevalence of psychological distress and its associated factors in patients with breast cancer.

Design
Systematic review and meta-analysis.

Data sources
PubMed, Web of Science, Embase, the Cochrane Library, China National Knowledge Infrastructure and Wanfang were searched from inception to 11 June 2024.

Eligibility criteria
Studies reported data on the prevalence and correlates of psychological distress were included. Review, letter, conference abstracts and articles not available in English and Chinese were excluded.

Data extraction and synthesis
Two researchers independently conducted literature screening, data extraction and bias risk assessment. Meta-analysis was employed to estimate the prevalence and correlates of psychological distress in patients with breast cancer. The Agency for Healthcare Research and Quality and the Newcastle-Ottawa Scale were used for quality assessment. Meta-analysis was performed by using the R V.4.1.1 software.

Results
In total, 34 studies representing 13 828 patients with breast cancer were included in the study. Most of the studies were cross-sectional study (n=25, 73.53%%). The pooled prevalence of psychological distress was 50% (95% CI 42% to 58%, I2=98%). Results showed that psychological distress was positively correlated with younger age (z=0.13, 95% CI 0.07 to 0.20), having children (z=0.39, 95% CI 0.11 to 0.61), poor financial situation (z=0.12, 95% CI –0.03 to 0.26), short time since diagnosis (z=0.19, 95% CI 0.01 to 0.36), previous treatment (z=0.15, 95% CI 0.03 to 0.27), distant metastasis (z=0.31, 95% CI 0.07 to 0.52), chemotherapy (z=0.22, 95% CI 0.05 to 0.38), prior emotional status (z=0.40, 95% CI 0.29 to 0.50), body image damaged (z=0.10, 95% CI –0.01 to 0.21), negative coping (z=0.12, 95% CI –0.11 to 0.34), communication avoidance (z=0.32, 95% CI 0.24 to 0.39) and negatively correlated with married (z=–0.25, 95% CI 0.45 to –0.02), high education level (z=–0.19, 95% CI –0.40 to 0.05), having insured (z=–0.04, 95% CI –0.15 to 0.08), full employment (z=–0.40, 95% CI –0.61 to –0.14), time of completion of treatment (z=–0.12, 95% CI –0.30 to –0.06), surgery (z=–0.05, 95% CI –0.53 to 0.45), social support (z=–0.18, 95% CI –0.29 to –0.06), post-traumatic growth (z=–0.19, 95% CI –0.34 to –0.03), good physical conditions (z=–0.17, 95% CI –0.29 to –0.04), positive coping (z=–0.22, 95% CI –0.53 to 0.15).

Conclusion
Our findings indicated that the prevalence of psychological distress in patients with breast cancers was 50% and 21 correlates of psychological distress. Screening and evidence-based interventions are urgent and essential to address this public concern and promote the health of patients with breast cancer.

PROSPERO registration number
CRD42023397109.

Background
Non-compressible abdominal haemorrhage (NCAH) is a potentially preventable cause of death due to injury. Limited exploratory laparotomy by a non-surgeon is a temporary intervention to sustain life until definitive surgical intervention by trauma surgeons can be obtained. This study aims to establish consensus on a protocol for general surgery physician assistants performing limited exploratory laparotomy to manage NCAH in an austere environment.

Method
This study included anonymised trauma surgeons and general surgery physician assistants from military and civilian backgrounds. Participants were recruited from various professional surgical organisations, including direct interaction with trauma surgeons and surgical physician assistants. Participants used a modified Delphi survey with a 9-point Likert scale in two rounds. The two surveys were categorised into three parts: protocol for NCAH (part A), the potential role of general surgery physician assistants (part B) and measures of success (part C). A total of 24 statements were voted on and assessed. Votes were divided into three zones: agreement (median 7–9), uncertain (median 4–6) and disagreement (median 1–3). To reach a consensus, 70% agreement was required within a zone. If more than 30% of the votes fell outside of a specific zone, consensus was not achieved. After consensus, the original protocol was revised in an online meeting with experts.

Results
The initial analysis involved 29 participants. After 2 survey rounds, 19 out of 24 statements reached a consensus. Part A: 10 statements gained consensus, including in austere environments, controlling NCAH can be challenging. A qualified general surgery physician assistant should intervene. A focused assessment with sonography for trauma examination can be used for screening. Bleeding can be managed with packing and pressure. After managing the haemorrhage, the abdominal wall should be left open with a temporary closure technique. Part B: nine statements gained consensus, including in austere locations, a licensed general surgery physician assistant with a minimum of 3 years of experience working under the supervision of a trauma/general surgeon can perform interventions for limited exploratory laparotomy for patients with NCAH. Part C: general surgery physician assistants will be required to have the same success rates as any qualified surgeon.

Conclusion
Gaining consensus and implementing a revised protocol for managing NCAH by general surgery physician assistants is attainable. General surgery physician assistants will need formal training to manage NCAH. With the support of trauma surgeons who provide direct and indirect supervision, general surgery physician assistants can develop a comprehensive understanding of the necessary skills and make sound decisions when treating patients with this condition. This teamwork can also increase surgical capacity and potentially decrease mortality rates for patients with NCAH in austere environments.

Objectives
The global prevalence of mental health disorders has risen significantly since the beginning of the COVID-19 pandemic. The pandemic has additionally caused disruption to mental health services, leading to a shift from in-person to remote service delivery. Given its long-term impact, it has become critical to evaluate whether changes in health delivery during the pandemic have had an effect on prescribing patterns for commonly prescribed psychotropic drugs. This study aims to assess the impact of the COVID-19 pandemic on changes in psychotropic prescribing patterns in adults, as well as differences in prescribing in different healthcare delivery approaches across various geographical contexts.

Design and eligibility requirements
Systematic review of cohort, interrupted time-series and cross-sectional studies examining prescribing trends for at least one commonly prescribed psychotropic drug during and after COVID-19 in accessing care remotely or face to face between 1 January 2020 and 17 June 2022.

Data sources
MEDLINE, EMBASE, CINAHL, HMIC and PsycINFO databases were searched in addition to citation chaining of relevant reviews.

Extraction and analysis
Study screening, data extraction and quality assessment were completed by two independent reviewers. The PECO strategy was used to devise the systematic review and findings were synthesised narratively.

Results
16 studies were eligible for inclusion. Studies documenting changes in psychotropic prescribing trends provided very conflicting findings. There were no stark differences in prescribing outcomes between different healthcare delivery methods (ie, face-to-face consultations vs remote consultations). A noteworthy finding was that the prescribing rate of benzodiazepines was higher in women than men. No particular trends were observed for the prescription rates of hypnotics, antidepressants or antipsychotics.

Conclusions
Findings support mixed trends in the prescription of psychotropic medications in a range of settings, hindering conclusive statements on COVID-19’s impact on prescribing. In areas where remote consultations are in use, more comprehensive research is required to assess the safety of prescribing in these settings to inform public health policy and assess if the observed trends in our systematic review persist over time (given the increased consideration of remote and telehealth care in delivering services), particularly the safe and effective deployment of these services.