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L’altra emergenza segnalata dal report di Cittadinanzattiva è la difficoltà del rapporto tra cittadini, medici di famiglia e pediatri.
AISM, per migliorare la vita di oltre 140mila pazienti in Italia
Primo studio in Italia con l’arruolamento di 60 pazienti
Primo studio in Italia con l’arruolamento di 60 pazienti
Objectives
There is an increasing trend of pre-diabetes and diabetes mellitus (DM) among adolescents, and sub-Saharan Africa is no exception. However, few published data on pre-diabetes among adolescents in Sudan exist. We aimed to investigate the prevalence of and factors associated with pre-diabetes among adolescents in Eastern Sudan.
Design
A community-based cross-sectional study was conducted from August to October 2023.
Settings
This community-based study was conducted in Gadarif city, the capital of Gadarif state, Eastern Sudan.
Participants
Adolescents (within the ages of 10–19 years).
Main outcome measures
A questionnaire was used to collect socio-demographic information. Anthropometric and glycated haemoglobin (HbA1c) measurements were performed in accordance with standard procedures. Multivariate logistic regression analysis was performed.
Results
Of the 387 enrolled adolescents, 207 (53.5%) were female and 180 (46.5%) were male. The median (IQR) age was 14.0 (12.0–16.0) years. 39.5% of the participants’ fathers were employed. The median (IQR) HbA1c was 5.5% (5.2%–5.8%). One-third (32.6%) of the adolescents had pre-diabetes or DM. Of the participants, 67.4%, 30.0% and 2.6% had no DM, pre-diabetes or type 2 DM, respectively. In the univariate analysis, the father’s employment (OR=1.60, 95% CI=1.03 to 2.50) was associated with increased odds of pre-diabetes; age, sex, parents’ education, the mother’s occupation, body mass index z-score, cigarette smoking and a family history of DM were not associated with pre-diabetes. In the multivariate analysis, the father’s employment (adjusted OR=1.70, 95% CI=1.03 to 2.50) was associated with increased odds of pre-diabetes.
Conclusion
Pre-diabetes is a significant public health problem among adolescents in Eastern Sudan. The introduction of early screening programmes for pre-diabetes at the community level is recommended to halt the progression of pre-diabetes to DM and to deal with existing DM among adolescents.
Associazione pazienti, preoccupano nuovi Lea in vigore dal 2025
Associazione pazienti, preoccupano nuovi Lea in vigore dal 2025
This Viewpoint considers whether medical assistance in dying should be included as a tenet of palliative care medicine.
This randomized, multisite, comparative effectiveness trial investigates whether early palliative care delivered via video or in-person visits demonstrated equivalent effects on quality of life for patients with advanced non–small cell lung cancer and their caregivers.
Palliative care is not new. It evolved in the 1960s and 1970s before many other medical specialties, such as medical oncology, emergency medicine, and critical care medicine. Although it would be unimaginable to conceive of hospitals, cancer centers, or universities without these 3 specialties, for palliative care, the road toward recognized specialty and adoption by organized medicine was much more difficult, at least in part because of its origins in community hospices and palliative care teams rather than major academic centers and its focus on care of the person rather than more traditional biomedical issues.
Coordina l’Università Cattolica, approccio ‘vedo e curo’
Message Oesophageal strictures following circumferential endoscopic submucosal dissection (cESD) for extended early oesophageal cancer remain an unresolved issue since they are often treatment-refractory. We present a strategy to use topical steroids for submucosal injection during ESD followed by two postprocedural injection sessions. Doses between 70 and 120 mg of triamcinolone (2 mg/mL) were used. During a follow-up of a mean of 6 months (range: 3–12 months), only 1/9 of patients developed a stricture which resolved after one dilatation session. No adverse events were noted. This concept should be tested further in larger prospective trials. In more detail Oesophageal stricture after cESD is emerging as a major concern given that it occurs at a high rate of 100% and leads to poor quality of life.1–5 Despite the proposal of several approaches to prevent post-cESD stricture, these strategies…
Objectives
Paramedics have the potential to make a substantial contribution to community-based palliative care provision. However, they are hindered by a lack of policy and institutional support, as well as targeted education and training. This study aimed to elicit paramedics’, palliative care doctors’ and nurses’, general practitioners’, residential aged care nurses’ and bereaved families and carers’ attitudes and perspectives on how palliative paramedicine can be improved to better suit the needs of community-based patients, their families and carers, and the clinicians involved in delivering the care.
Design
In this qualitative study underpinned by a social constructivist epistemology, semistructured interviews were conducted.
Setting and participants
50 participants with palliative paramedicine experience, from all jurisdictions of Australia. Participants were interviewed between November 2021 and April 2022.
Results
All participants suggested paramedics play an important adjunct role in the provision of palliative and end-of-life care in home-based settings. Three levels of opportunities for improvement were identified: macrolevel (policy and frameworks; funding and education; accessing medical records and a widening scope); mesolevel (service-level training; interprofessional understanding and communities of practice and community expectations) and microlevel (palliative care subspecialty; debriefing and self-care and partnering with families).
Conclusion
To enhance paramedic capacity to provide palliative care support, improvements targeting systems, services, communities and individuals should be made. This calls for stronger inclusion of paramedicine in interdisciplinary palliative care and greater investment in both the generalist and specialist palliative paramedicine workforce.
Despite including over 100 studies with more than 1500 predictors, we were unable to pool any single maternal outcomes and only a few individual perinatal outcomes. The fullPIERS model was externally validated, showing moderate accuracy which varied across studies and should be validated in each new population. Angiogenic biomarkers showed promise but need validation. Future studies should use standardized outcome measures and validate promising tests.
Importante momento formativo organizzato dall’Ars in Regione
‘Altre 2 aggressioni in 24 ore. E’ un’emergenza costituzionale’
