Risultati per: Test delle urine per la diagnosi di cancro

Objectives
The study aimed to assess the predictors of upper limb motor recovery in stroke survivors.

Design
Pre–post test study design.

Setting
Conducted in two centres (First Level Hospital and University Teaching Hospital in Lusaka).

Participants
Patients living with stroke accessing physiotherapy services at the two public hospitals. A total of 52 patients were recruited at the start of the study, 6 were lost to follow-up and 46 completed the study.

Intervention
Conventional physiotherapy for 8 weeks (5 September 2022–28 October 2022).

Primary outcome
Motor function measured using a Fugl-Meyer assessment of the upper extremity.

Results
Analysis was conducted on 46 participants. A significant difference was observed between the level of motor function at baseline and after 8 weeks of treatment (p=0.0183). At baseline, 50% of participants had mild motor function, which improved after 8 weeks, with 69.6% having mild motor function. Stroke patients with severe motor function impairment at baseline were associated with 0.01 times likelihood of having mild motor function impairment after 8 weeks of physiotherapy treatment (AOR 0.01; 95 % CI 0.00 to 0.16; p=0.002).

Conclusion
The motor function of stroke patients continues to improve over time. This study demonstrated that initial upper limb motor function impairment could be used as a predictor for upper limb motor function.

Objectives
There is limited research on real-world effectiveness of BBIBP-CorV Sinopharm COVID-19 vaccine. This study evaluated real-world effectiveness of Sinopharm vaccine in Sri Lanka by assessing absolute vaccine efficacy.

Design and setting
A retrospective test-negative case-control study was conducted at ten large government hospitals across the country.

Participants
Consecutive adults aged ≥18 years attending outpatient departments who tested reverse-transcription-PCR positive for SARS-CoV-2 during the study period were recruited.

Main outcome measures
An interviewer-administered questionnaire was administered, and outcome of COVID-19 infection was assessed in cases.

Results
Of 1829 recruited, 914 (49.9%) were male, and mean age was 45.2 (SD 15.3) years; 1634 (89.3%) were vaccinated with two doses of BBIBP-CorV Sinopharm vaccine, while 195 (10.1%) were vaccine-naïve. Compared with the vaccinated, unvaccinated persons were older but otherwise similar in their demographic and medical profiles. Unvaccinated were more likely to have fever, shortness of breath and vomiting as symptoms and were more likely to seek treatment. Significantly more vaccinated individuals received treatment at home. After admission, the unvaccinated were more likely to receive oxygen. Significantly more unvaccinated persons died of COVID-19 compared with the vaccinated. Sinopharm vaccine was 78.2% (94% CI 69.0% to 85.0%) effective at preventing COVID-19 infection, 88.7% (81.6%–93.2%) effective at preventing severe infection and 85.6% (69.6%–93.6%) effective at preventing death.

Conclusions
BBIBP-CorV Sinopharm vaccine is effective at mitigating severity of illness and reducing the likelihood of hospitalisation, severe illness and death, in those who received primary vaccination, compared with the unvaccinated.

Capace di indurre una risposta immunitaria più completa

Introduction
The TriAD study will assess the Xpert MTB/XDR (Xpert XDR; Cepheid) assay to detect tuberculosis (TB) drug resistance in sputum testing positive for TB to rapidly triage and treat patients with a short all-oral treatment regimen.

Methods and analysis
In this study, approximately 4800 Xpert MTB/RIF or Ultra MTB-positive patients (irrespective of rifampicin (RIF) resistance (RR) status) from several clinical sites across South Africa, Nigeria and Ethiopia will be enrolled over 18–24 months and followed-up for approximately 6 months post-TB treatment completion. Participants will be enrolled into one of two cohorts based on Xpert MTB/RIF and Xpert XDR results: Mycobacterium tuberculosis (M.tb) positive participants with RR in Cohort 1 (n=880) and M.tb positive RIF susceptible TB patients with isoniazid mono-resistance irrespective of presence of resistance to fluoroquinolones, second-line injectable drugs or ethionamide in Cohort 2 (n=400). Cohort 1 will be compared with historical cohorts from each implementing sites. The primary study outcomes include time to initiation of an appropriate treatment regimen by resistance profile and the proportion of patients with favourable treatment outcomes compared with historical cohorts from each of the implementing sites. Secondary outcomes include feasibility, acceptability and cost-effectiveness of this approach to inform policies and guidelines for programmatic implementation of this triage and treat model for drug-resistant tuberculosis management. Utility of the tuberculosis molecular bacterial load assay (TB-MBLA) for real-time treatment response assessment will also be evaluated.

Ethics and dissemination
The University of KwaZulu-Natal Biomedical Research Ethics Committee (BREC) and local research committees have provided ethical review and approval (BREC/00002654/2021, HREC 210805, NHREC/01/01/2007 and EPHI-IRB-459–2022). The South African Health Products Regulatory Authority (SAHPRA) have granted regulatory approval for the TRiAD Study (SAHPRA MD20211001). Trial results will be disseminated through conference presentations, peer-reviewed publications and the clinical trial registry.

Trial registration number
Clinicaltrials.gov; Trial registration number: NCT05175794; South African National Clinical Trials Register (SANCTR DOH-27-012022-4720)

Università Cattolica, il farmaco ‘spegne’ un enzima nel cervello

Focus su tumori ereditari e immunità nei contesti oncologici

Univ. Cattolica, svelato nuovo bersaglio cure

Serve a rilevare l’infezione da Helicobacter pylori

Objective
Real-time access to test results on patient portals can have advantages and disadvantages for patients. It confronts patients with a complicated decision, namely whether to consult results before the medical consultation. To gain a deep understanding of patients’ decision-making processes, we unravelled three discourses about real-time access to test results, each of which articulates a different set of values, assumptions and arguments. Our research question was what patient discourses on real-time access to test results can be distinguished?

Design
We conducted discourse analysis on 28 semistructured interviews.

Setting
Interviews were conducted with patients who had (no) experience with real-time access to test results. Our participants were treated in different hospitals, and therefore, used different portals since Dutch hospitals can choose from suppliers for their patient portals.

Participants
Patients with experience (n=15) and without experience (n=13) of real-time access to test results on a patient portal.

Results
We identified three discourses: (1) real-time access as a source of stress, which highlighted how real-time access could cause stress due to the complexity of deciding whether to access test results, the incomprehensibility of medical language and the urge to repeatedly check if test results were available, (2) anxiety reduction through real-time access showed how real-time access can reduce stress by reducing waiting times and (3) real-time access for self-management showed how real-time access can give patients an opportunity for self-management because they can make informed decisions and are better prepared for the medical consultation.

Conclusion
Our study shows the plurality in opinions on real-time access, which helps in forming different strategies to inform and support patients in order to realise optimal use of real-time access.

Nel 2023 tornati ai livelli pre covid. Maschi i più colpiti

Focus anche sul trattamento innovativo e riabilitativo

In Reply Our study adjusted the FIT cutoff to yield the same overall positivity rate as reported for the mt-sRNA test (17%) to enhance comparability of diagnostic performance of both tests. Below we address each of the 3 points made by Drs Yang and Ma.

Too few patients with abnormal urine protein dipstick test results receive the recommended follow-up with albumin to creatinine ratio (ACR) testing to assess albuminuria, a risk factor for chronic kidney disease, according to new research published in the Annals of Internal Medicine.

Gastric cancer is a leading cause of cancer death globally. Although endoscopy-based screening has led to a decrease in gastric cancer mortality in Eastern Asian countries with populations at high risk, lack of risk stratification and the cost of health care infrastructure and trained personnel limit its use in most of the world. Availability of noninvasive biomarkers for the identification of high-risk individuals could optimize endoscopy-based screening programs for a more general application, including in regions where gastric cancer rates in the general population are low.

To the Editor We read with interest the recent study that compared the fecal immunochemical test (FIT) positivity threshold vs multitarget stool RNA (mt-sRNA) testing for colorectal cancer screening. However, we have concerns regarding the study methodology and the capability of FIT to fully replace the mt-sRNA panel.