Risultati per: Demenza: carenze vitaminiche e nutrizionali nei deficit cognitivi: quali evidenze?

Importance and objective
Prenatal cannabis effect on attention deficit with or without hyperactivity disorder (ADHD) remains to be determined. Our aim is to quantify the impact of in-utero exposure to cannabis on the risk of ADHD.

Design
Cohort study.

Setting
Questionnaires were mailed to women sampled from the Quebec Pregnancy Cohort (QPC). Data from questionnaires were then linked with their QPC (built with administrative health databases, hospital patient charts and birth certificate databases).

Participants
Respondents who gave birth to a singleton live born between January 1998 and December 2003 and were continuously enrolled in the Régie de l’assurance maladie du Québec (RAMQ) medication insurance plan for at least 12 months before the first day of gestation and during pregnancy.

Exposure
In-utero cannabis exposure was based on mothers’ answers to the question on cannabis use during pregnancy (yes/no) and categorised as occasionally, regularly exposed and unexposed if they chose one of these categories.

Outcomes
ADHD was defined by a diagnosis of ADHD through the RAMQ medical services or MedEcho databases or a prescription filled for ADHD medication through RAMQ pharmaceutical services between birth and the end of the follow-up period. Follow-up started at the birth and ended at the index date (first diagnosis or prescription filled for ADHD), child death (censoring), end of public coverage for medications (censoring) or the end of study period, which was December 2015 (censoring), whichever event came first.

Results
A total of 2408 children met the inclusion criteria. Of these children, 86 (3.6%) were exposed to cannabis in-utero and 241 (10.0%) had an ADHD diagnosis or medication filled. After adjustments for potential confounders, no significant association was found between in-utero cannabis exposure (occasional (1.22 (95% CI 0.63 to 2.19)) or regular (1.22 (95% CI 0.42 to 2.79))) and the risk of ADHD in children.

Conclusions
In-utero exposure to cannabis seemed to not be associated with the risk ADHD in children.

Introduction
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders and is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with daily functioning. Children with ADHD are developmentally vulnerable, with the disorder linked to emotional regulation difficulties, behavioural disturbances, as well as academic challenges. Emerging evidence suggests that children with ADHD may benefit from cognitive training interventions, including those focused on attention. This study aims to assess the immediate and long-term efficacy of an attention training intervention in children with ADHD.

Methods and analysis
This study is a preregistered, parallel, double blind, randomised controlled trial. Participants will comprise 104 children with a diagnosis of ADHD aged 5–8 years 11 months. Participants will be randomly allocated to either an adaptive, digital game-based (1) attention training programme (intervention) or (2) a numeracy programme (control). Both programmes will be delivered on a touchscreen tablet, and children will complete five 20 min sessions per week for a 5-week period at home (25 sessions in total). Assessments of the primary outcome (ie, attention and inhibitory control) and secondary outcomes (ie, selective attention, interference control, sustained attention, inhibition, behavioural attention, impairment in everyday functioning, working memory and executive functioning) will occur at preintervention, immediately postintervention and at 3-month follow-up. Multivariate linear regression will be employed to examine primary and secondary outcomes. The data analyst will be blinded to group membership.

Ethics and dissemination
Ethics approval has been obtained from the Monash University HREC (20495). Results will be disseminated through peer-reviewed journals, conference presentations, media outlets, the internet and various community/stakeholder activities.

Trial registration number
ACTRN12620000964910, UTN U1111-1250-2620.

Secondo quanto emerge dal Rapporto civico sulla salute 2022 di Cittadinanzattiva, la sanità post pandemia ha cancellato troppi screening, allungato le liste d’attesa e considerato poco l’assistenza domiciliare. Le differenze regionali sono importanti e serve un intervento coordinato che, grazie ai fondi del Pnrr, è possibile. Per gli esperti la vera sfida è culturale

Stroke, Volume 53, Issue Suppl_1, Page AWP151-AWP151, February 1, 2022. Background and Purpose:This study aimed to investigate the efficacy and safety of endovascular treatment (EVT) in patients with acute basilar artery occlusion and moderate deficit (National Institutes of Health Stroke Scale [NIHSS] score 10 to 20) versus standard medication treatment (SMT) alone.Methods:Patients from a nationwide prospective registry termed BASILAR (the Endovascular Treatment for Acute Basilar Artery Occlusion Study) were divided into three kinds of population according to NIHSS, including patients with mild deficit (NIHSS score 20). Then patients with moderate deficit were identified and divided into two groups for analysis: EVT group or SMT-alone group. The primary efficacy outcome was a favorable functional outcome (modified Rankin Scale score 0-3) at 90 days and safety outcomes were symptomatic intracerebral hemorrhage and mortality at 90 days.Results:A total of 194 patients had moderate deficit of which 47 patients treated with SMT-alone and 147 patients treated with EVT. Compared with patients in the SMT-alone group, patients undergoing EVT were associated with significant higher proportion of 90-day modified Rankin Scale scores of 3 or less (adjusted odds ratio, 3.36 [95%CI, 1.14-9.92];P= .028) but no statistically significant difference was found in 90-day mortality (adjusted odds ratio, 0.53 [95% CI, 0.25-1.14];P= .10) despite a higher rate of symptomatic intracerebral hemorrhage (4 of 146 patients [2.7%] vs 0 of 47 patients [0%]).Conclusions:This study suggests that EVT in acute basilar artery occlusion patients with moderate deficit may be associated with better functional outcomes. More randomized clinical trials were in need to explore the management of these patients.