Risultati per: Le campagne di screening come strumento di prevenzione oncologica tra dubbi e certezze

Prevalence of advanced neoplasm was much lower at repeat screening colonoscopies than at all screening colonoscopies.

Background
In elite football, periodic health examination (PHE) may be useful for injury risk prediction.

Objective
To explore whether PHE-derived variables are prognostic factors for indirect muscle injuries (IMIs) in elite players.

Design
Retrospective cohort study.

Setting
An English Premier League football club.

Participants
134 outfield elite male players, over 5 seasons (1 July 2013–19 May 2018).

Outcome and analysis
The outcome was any time-loss, lower extremity index IMI (I-IMI). Prognostic associations were estimated using odds ratios (ORs) and corresponding statistical significance for 36 variables, derived from univariable and multivariable logistic regression models. Missing data were handled using multiple imputation. Non-linear associations were explored using fractional polynomials.

Results
During 317 participant-seasons, 138 I-IMIs were recorded. Univariable associations were determined for previous calf IMI frequency (OR 1.80, 95% CI 1.09 to 2.97), hamstring IMI frequency (OR 1.56, 95% CI 1.17 to 2.09), if the most recent hamstring IMI occurred >12 months but 12 months but 12 months but

In piazze,scuole e bar.Oltre 137 mln per lotta a cancro nel 2023

Obiettivo progetto internazionale con ricercatori italiani

Objectives
A cross-sectional and a policy document review study was performed to investigate perceived acceptability and feasibility to implementing different integration measures for tuberculosis (TB) and diabetes mellitus (DM) healthcare among healthcare workers (HCWs) and health managers, and to describe policy influence through a policy documents review in Malawi.

Setting
The survey was performed at eight hospitals, ministry of health offices and 10 non-governmental organisations. We collected data in March and April 2021.

Participants
Of 95 HCWs and health managers invited; 92 participated. 21/92 (23%) were female, and 17/92 (18%) participants were from clinics that piloted the integrated care for TB and DM.

Outcome measures
We described awareness levels on TB/DM comorbidity, perceptions and experiences in TB/DM care. Furthermore, development processes and contents of included documents were analysed.

Results
16/17 (94%) of HCWs from clinics piloting integrated care and 65/75 (86%) HCWs from hospitals that do not use integrated care for TB and DM responded that integrated care was acceptable and feasible. In qualitative data, shortage of resources, inadequate information sharing were common themes. We included seven relevant documents for the analysis. On development process and content, six of seven documents were scored ≥70%. In these documents, DM is a recognised risk factor for TB, and integration of healthcare services for infectious diseases and non-communicable diseases is recommended, however, these documents lacked information specifically on integrated care for TB and DM.

Conclusion
In this study, we identified inadequate information sharing, and lack of resources as major factors impeding implementation of integration of services, however, awareness on TB/DM comorbidity was high.

Objective
The Surviving Sepsis Campaign guidelines recommend the implementation of systematic screening for sepsis. We aimed to validate a paediatric sepsis screening tool and derive a simplified screening tool.

Design
Prospective multicentre study conducted between August 2018 and December 2019. We assessed the performance of the paediatric sepsis screening tool using stepwise multiple logistic regression analyses with 10-fold cross-validation and evaluated the final model at defined risk thresholds.

Setting
Twelve emergency departments (EDs) in Queensland, Australia.

Participants
3473 children screened for sepsis, of which 523 (15.1%) were diagnosed with sepsis.

Interventions
A 32-item paediatric sepsis screening tool including rapidly available information from triage, risk factors and targeted physical examination.

Primary outcome measure
Senior medical officer-diagnosed sepsis combined with the administration of intravenous antibiotics in the ED.

Results
The 32-item paediatric sepsis screening tool had good predictive performance (area under the receiver operating characteristic curve (AUC) 0.80, 95% CI 0.78 to 0.82). A simplified tool containing 16 of 32 criteria had comparable performance and retained an AUC of 0.80 (95% CI 0.78 to 0.82). To reach a sensitivity of 90% (95% CI 87% to 92%), the final model achieved a specificity of 51% (95% CI 49% to 53%). Sensitivity analyses using the outcomes of sepsis-associated organ dysfunction (AUC 0.84, 95% CI 0.81 to 0.87) and septic shock (AUC 0.84, 95% CI 0.81 to 0.88) confirmed the main results.

Conclusions
A simplified paediatric sepsis screening tool performed well to identify children with sepsis in the ED. Implementation of sepsis screening tools may improve the timely recognition and treatment of sepsis.

This economic evaluation study of Swedish men compares the cost-effectiveness of magnetic resonance imaging–aided screening for prostate cancer with strategies using no screening or prostate-specific antigen alone.

This cross-sectional study analyzes patterns in the rates of routine screening and diagnosis for breast, cervical, and colorectal cancer before and after the COVID-19 pandemic.

Solid organ transplant recipients (SOTRs) are at an increased risk for developing skin cancers compared with the general population. The increased risk of skin cancer among SOTRs is 65-fold greater for cutaneous squamous cell carcinoma (cSCC), 10-fold greater for basal cell carcinoma (BCC), and 3-fold greater for malignant melanoma (MM). The risk of posttransplant skin cancer increases gradually over time after transplantation; however, a subset of SOTRs may present with earlier-onset skin cancer based on various risk factors, requiring timely evaluation and treatment by a dermatologist. With more than 400 000 living transplant recipients and more than 30 000 transplant procedures performed annually in the US, it is not feasible for all SOTRs to receive annual skin cancer screening. Risk-based screening considers the feasibility of access to dermatologic care in a resource-limited setting and helps define which patients need more urgent referral to dermatology.

This quality improvement study analyzes the rate of failures in entrance screening for COVID-19 among individuals entering a large academic medical center.

Entrance surveillance screenings have been widely implemented in health care settings during the COVID-19 pandemic. These measures, which are required by the US Department of Labor, rely on self-reported factors such as symptoms or exposure history and are intended to reduce risk to patients and health care workers. In this issue of JAMA Internal Medicine, Roberts and colleagues examine the usefulness of entrance surveillance screenings at a single academic medical center. They find that during the first wave of the pandemic, about 1 in every 38 people screened positive. However, during later periods, the catch rate was considerably lower, closer to 1 in every 3000 people. This lower rate was constant regardless of community incidence of disease. It cannot be known from their findings if the screening requirement itself acted as a deterrent to those who might have otherwise sought entry to the health care center. Awareness of the screening procedure or of the nature of COVID-19 symptoms may have increased over the course of time.

This cross-sectional study examines annual use trends in cervical cancer screening–associated services in Medicare fee-for-service beneficiaries and estimates expenditures for services.

Sars-Cov-2 fa meno paura ma crescono carenza medici e zoonosi

Progetto Sapienza e Umberto I con Atena Onlus, collabora la Lilt

Objectives
To identify the prevalence of diabetes among adults ( >18 years) living in residential care facilities in Denmark and to identify the structural, practical, and individual barriers and drivers related to their participation in screening programmes.

Design

Setting
The register-based study included all residents living in residential care facilities in Denmark. The survey and qualitative analysis were carried out exclusively in the Capital Region of Denmark.

Participants
For the register-based study, we identified 11 620 residents of care facilities in Denmark ( >18 years) and identified the number of residents with diagnosis codes of type 1 or type 2 diabetes or dispensed prescriptions of blood glucose-lowering medication. Staff from 102 psychiatric facilities housing adults with severe psychiatric disabilities were invited to participate in the survey. Of these, 56 facilities participated with one responder each, of which n=16 also participated in follow-up qualitative interviews.

Results
Register-based study: of the residents at the facilities, 954 (8%) were diagnosed with diabetes. Descriptive statistics of responses and results from content analysis of interviews were summarised in five themes that illuminated how a screening programme could be tailored to the care facilities: (1) characteristics of residents and care facilities, (2) the care needs of residents, (3) the way care was organised, (4) the specific barriers and drivers for participating in programmes, (5) number of hours and settings for screening programmes.

Conclusion
To increase the participation of people living in psychiatric care facilities in screening programmes, future programmes should be tailored to the identified needs and barriers experienced by the residential care staff.