Search Results for: La qualità dei nutraceutici e position paper per l’appropriato uso in medicina generale

Impatta l’aumento rispetto a proprio uso medio

Introduction
The COVID-19 pandemic has had a significant impact on medical education, with many institutions shifting to online learning to ensure the safety of students and staff. However, there appears to be a decline in in-person attendance at medical schools across the UK and worldwide following the relaxation of social distancing rules and the reinstatement of in-person teaching. Importantly, this trend was also observed before the pandemic. While reflected within the literature, there is currently no systematic review describing these changes. We aim to find out how medical students’ attendance is changing as documented within the literature and its impact on their educational outcomes.

Methods
This systematic review followed the guidelines of the Centre of Research and Dissemination, Moose and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched the major databases of Medline via Ovid, Embase via Ovid, Scopus, Web of Science, British Education Index via EBSCOhost and ERIC via EBSCOhost in September 2023. Two reviewers independently screened each paper and extracted the data, with a third reviewer for dispute resolution. All studies reporting on medical students from various universities, both graduate and undergraduate, and describing changes in attendance and/or students’ educational outcomes were included. Risk of bias in individual studies was assessed using the Agency for Healthcare Research and Quality tool. A narrative synthesis of the findings from all included studies was done.

Results
12 papers were included in the analysis. Primary aim: Of the eight papers that measured attendance data over more than one academic year, only one paper demonstrated a statistically significant decrease while one paper demonstrated a statistically significant increase in attendance over the observational period. Other papers either did not perform statistical tests or did not demonstrate statistical significance. Secondary aims: Most papers showed a general positive correlation between attendance and educational outcomes. No studies explicitly explored reasons for changes in attendance seen. Only one paper outlined a possible strategy to address changes in attendance, a mandatory attendance policy, which has mixed outcomes.

Discussion
Despite widespread anecdotally reported attendance decline post-COVID-19, overall, there was no consistent change in attendance noted. However, there was a large heterogeneity in the studies included. Further research is required to elucidate trends in attendance and its impact on medical education.

Segretario generale Ghebreyesus: prevalenza ridotta di un terzo

Objectives
Suicide rates in India are among the highest in the world, with the most recent suicide death rate estimates ranging between 18 and 21 deaths per 100 000 population (compared with the global average of 11/100 000). Responsible media reporting of suicide is one of the few evidence-based population-level suicide prevention interventions. Reports of recent suicides are a routine daily feature in major newspapers in India, and the reporting style carries many concerning features. In 2019, the Press Council of India adopted the WHO media guidelines, yet there has been no investigation as to whether this guidance is being followed. The aim of this paper was to systematically investigate whether the quality of print media reports of suicides has changed since the adoption of media guidelines for suicide reporting in India.

Design
We used content analysis to assess the quality of suicide reporting against WHO guidelines in nine of the most highly read daily newspapers in the southern state of Tamil Nadu between June and December 2016 and June and December 2023. Our analyses of changes in reporting were based on a sample of 1681 print newspaper articles from 2016 and 512 print newspaper articles from 2023. Two-tailed t-tests and proportion tests on aggregate means and frequencies assessed whether the reporting characteristics had changed between 2016 and 2023.

Results
There were small yet statistically discernible reductions in the proportion of articles containing various potentially harmful reporting characteristics, such as articles placed on the front page (4.9–1.8%, p=0.002) and articles mentioning the suicide method (92.7–86.5%, p

Ministero, 2 milioni di morti l’anno nel mondo per il troppo uso

Sime, ‘ossessionati dal dover esser belli a tutti i costi, tanta la pressione sociale. Attenzione ai finti dottori ed ai super sconti’

Objectives
To observe the association between passive leg raising (PLR) and the cross-sectional area (CSA) of the right internal jugular vein (IJV) in obese patients undergoing elective surgery.

Design
Prospective observational study with randomised position sequence.

Setting
Single-centre, tertiary care hospital in Shanghai, China.

Participants
Forty obese patients (body mass index (BMI) >30 kg/m²) scheduled for elective surgery were enrolled. Inclusion criteria were American Society of Anesthesiologists Physical Status Classification (ASA) physical status II–III and age ≥18 years. Exclusion criteria included history of neck surgery, severe cardiovascular disease, end-stage renal disease, severe infection or sepsis and significant coagulopathy.

Observations
Patients underwent ultrasound measurements of the right IJV in two positions: supine (S0) and passive leg raise at 40° (PLR40). Each position was maintained for at least 1 min prior to measurement.

Primary outcome
The primary outcome was to observe whether the CSA of the right IJV differed between the S0 position and passive leg elevation. In post hoc analyses, we examined factors affecting the relative CSA change (CSA), including neck circumference, BMI, age, sex, ASA physical status and heart rate as predictors.

Results
The CSA of the right IJV was significantly larger in the PLR40 position (2.05 cm²) compared to the S0 position (1.67 cm², p=0.003). Linear regression analysis showed a slight positive correlation between neck circumference and the percentage change in CSA (correlation coefficient: 0.066, p

L’ex ministro della Salute,”difendere Snn e medicina territorio”

Gli internisti: il 58% in overbooking, ma è evitabile 1 ricovero su 3

Indagine internisti, posti occupati oltre il 100%. Pazienti su Lettighe nei corridoi. Carenza cronica di medici e infermieri nell’85% delle strutture

Bertolaso, miglioriamo qualità vita per chi opera in ospedali

Accordo integrativo, 8,5 milioni per Aft e sanità territoriale

Message Computer-aided detection (CADe) has increased adenoma detection in randomised trials. However, unlike other detection adjuncts, CADe is lesion specific, that is, it is trained on a specific set of lesions. If the training does not include sufficient examples of precancerous lesion subsets, CADe may not perform adequately for lesions in that subset. In a prospective assessment of a second-generation CADe programme in 165 colonoscopies, we identified 26 flat lesions ≥10 mm in 17 patients. The endoscopist identified 22 of 26 lesions before the CADe programme. In 13 lesions, the CADe either generated no detection signal or only a signal over part of the lesion after colonoscope position or luminal inflation adjustment. Thus, the second-generation CADe algorithm, like the first generation, frequently fails to effectively detect large flat colorectal lesions, which are likely very important lesions that a CADe programme should identify. Details The first CADe…

Thanks to Dr Zeng for his insightful comments1 about our recent publication on 12-month outcomes of endoscopic retrograde cholangiopancreatography (ERCP) for sphincterotomy for sphincter of Oddi disorders (SOD).2 Many of the comments were addressed in the discussion of the paper, especially the significance of the unmeasured placebo response and greater importance of patient characteristics such as somatisation and opioid exposure compared with physician-defined factors like a dilated duct. We disagree that RESPOnD’s heterogeneous patient population reduces the study’s generalisability. RESPOnD subjects represent the full spectrum of SOD subtypes and thus have lower selection bias compared with more stringent enrolment criteria. For example, restricting subjects to those with a dilated bile duct would have precluded our observation that duct size correlated poorly with response to sphincterotomy. As noted by Dr Zeng, sphincterotomy does not seem to be a promising intervention for idiopathic acute recurrent pancreatitis because…