Risultati per: Linee guida ESC/ERS 2022 per la diagnosi e il trattamento dell'ipertensione polmonare

Objective
To assess the patterns of antibiotic consumption and expenditure in Vietnam.

Design
This was a cross-sectional study.

Setting
This study used data of antibiotic procurement that was publicly announced from 2018 to 2022 as a proxy for antibiotic consumption.

Participants
This study included winning bids from 390 procurement units in 63 provinces in Vietnam for 5 years with a total expenditure of US$ 12.8 billions that represented for approximately 20–30% of the national funds spend on medicines.

Interventions
Antibiotics were classified by WHO AWaRe (Access, Watch and Reserve) classification.

Outcome measures
The primary outcomes were the proportions of antibiotic consumptions in number of defined daily doses (DDD) and expenditures.

Results
There was a total of 2.54 million DDDs of systemic antibiotics, which accounted for 24.7% (US $3.16 billions) of total expenditure for medicines purchased by these public health facilities. The overall proportion of Access group antibiotics ranges from 40.9% to 53.8% of the total antibiotic consumption over 5 years.

Conclusion
This analysis identifies an unmet target of at least 60% of the total antibiotic consumption being Access group antibiotics and an unreasonable share of expenditure for non-essential antibiotics in public hospitals in Vietnam.

La richiesta del passaporto ai servizi veterinari delle asl

Objective
To determine the prevalence and factors associated with anxiety and depression and the care-seeking behaviour among Nepalese population.

Design and settings
Secondary analysis of the data from nationally representative Nepal Demographic and Health Survey 2022.

Participants
Analysed data of 12 355 participants (7442 females and 4913 males) aged 15–49 years.

Outcome measures
Depression and anxiety were assessed using Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder Assessment (GAD-7) tools, respectively.

Statistical analysis
We performed weighted analysis to account for the complex survey design. We presented categorical variables as frequency, per cent and 95% confidence interval (CI), whereas numerical variables were presented as median, inter-quartile range (IQR) and 95% CI. We performed univariate and multivariable logistic regression to determine factors associated with anxiety and depression, and results were presented as crude OR (COR), adjusted OR (AOR) and their 95% CI.

Results
The prevalence of depression and anxiety were 4.0% (95% CI 3.5 to 4.5) and 17.7% (95% CI 16.5 to 18.9), respectively. Divorced or separated participants were found to have higher odds of developing anxiety (AOR 2.40, 95% CI 1.74 to 3.31) and depression (AOR 3.16, 95% CI 1.84 to 5.42). Among ethnic groups, Janajati had lower odds of developing anxiety (AOR 0.77, 95% CI 0.65 to 0.92) and depression (AOR 0.67, 95% CI 0.49 to 0.93) compared with Brahmin/Chhetri. Regarding disability, participants with some difficulty had higher odds of developing anxiety (AOR 1.81, 95% CI 1.56 to 2.10) and depression (AOR 1.94, 95% CI 1.51 to 2.49), and those with a lot of difficulty had higher odds of anxiety (AOR 2.09, 95% CI 1.48 to 2.96) and depression (AOR 2.04, 95% CI 1.06 to 3.90) compared with those without any disability. Among those who had symptoms of anxiety or depression, only 32.9% (95% CI 30.4 to 34.4) sought help for the conditions.

Conclusions
Marital status and disability status were positively associated with anxiety and depression, whereas Janajati ethnicity had relatively lower odds of experiencing anxiety and depression. It is essential to develop interventions and policies targeting females and divorced individuals to help reduce the burden of anxiety and depression in Nepal.

Objective
This study aims to assess the survival status and predictors of mortality among under-5 children with severe acute malnutrition in Addis Ababa, Ethiopia.

Design
A retrospective cohort study was employed on randomly selected 422 medical records of children under the age of 5 admitted to stabilisation centres in Addis Ababa, Ethiopia. Survival analysis and Cox regression analysis were conducted to determine time spent before the outcome and predictors of desired outcome.

Settings
The stabilisation centres in four governmental hospitals in Addis Ababa, Ethiopia: Tikur Anbessa Specialised Hospital, Zewditu Memorial Hospital, Yekatit 12 Hospital and Tirunesh Beijing Hospital

Participants
Of 435 severely malnourished children under the age of 5 admitted to four governmental hospitals in Addis Ababa, Ethiopia, from January 2020 to December 2022, we were able to trace 422 complete records. The remaining 13 medical records were found to be incomplete due to missing medical history information for those children.

Primary and secondary outcome measures
The primary outcome is the survival status of under-5 children with severe acute malnutrition after admission to the stabilisation centres. The secondary outcome is predictors of survival among these children.

Results
Of 422 children, 44 (10.4%) died, with an incidence rate of 10.3 per 1000 person-days. The median hospital stay was 8 days. Full vaccination (adjusted HR (AHR) 0.2, 95% CI 0.088 to 0.583, p

Objectives
Inappropriate prescribing of antibiotics is a key driver of antimicrobial resistance. This study aimed to describe urine sampling rates and antibiotic prescribing for patients with lower urinary tract infections (UTIs) in English general practice.

Design
A retrospective population-based study using administrative data.

Setting
IQVIA Medical Research Database (IMRD) data from general practices in England, 2015–2022.

Participants
Patients who have consulted with an uncomplicated UTI in England general practices captured in the IMRD.

Outcome measures
Trends in UTI episodes (episodes were defined as UTI diagnosis codes occurring within 14 days of each other), testing and antibiotic prescribing on the same day as initial UTI consultation were assessed from January 2015 to December 2022. Associations, using univariate and multivariate logistic regressions, were examined between consultation and demographic factors on the odds of a urine test.

Results
There were 743 350 UTI episodes; 50.8% had a urine test. Testing rates fluctuated with an upward trend and large decline in 2020. Same-day UTI antibiotic prescribing occurred in 78.2% of episodes. In multivariate modelling, factors found to decrease odds of a urine test included age ≥85 years (0.83, 95% CI 0.82 to 0.84), consultation type (remote vs face to face, 0.45, 95% CI 0.45 to 0.46), episodes in London compared with the South (0.74, 95% CI 0.72 to 0.75) and increasing practice size (0.77, 95% CI 0.76 to 0.78). Odds of urine tests increased in males (OR 1.11, 95% CI 1.10 to 1.13), for those episodes without a same-day UTI antibiotic (1.10, 95% CI 1.04 to 1.16) for episodes for those with higher deprivation status (Indices of Multiple Deprivation 8 vs 1, 1.51, 95% CI 1.48 to 1.54). Compared with 2015, 2016–2019 saw increased odds of testing while 2020 and 2021 saw decreases, with 2022 showing increased odds.

Conclusion
Urine testing for UTI in general practice in England showed an upward trend, with same-day antibiotic prescribing remaining consistent, suggesting greater alignment to national guidelines. The COVID-19 pandemic impacted testing rates, though as of 2022, they began to recover.

Proteggere il cuoio capelluti e curare l’igiene delle lenti

This cross-sectional study investigates the prevalence of up-to-date lung cancer screening across the 50 US states and the District of Columbia in 2022.

Con dose giornaliera in casa di polvere di arachidi

Background
Telesurgery has become helpful in overcoming the current shortage of surgeons and reducing the barriers to timely and effective surgical intervention caused by long-distance travel, which is caused by distance, cost, complexity and frequent hazards. However, knowledge and attitude remain challenges in the implementation of such a system.

Objective
This study aimed to assess physicians’ knowledge and attitude towards telesurgery and associated factors at resource-limited setting, Northwest Ethiopia.

Method and analysis
A simple random sampling method was carried out to choose study participants from each referral hospital, and data were collected using self-administered questionnaires. Descriptive and inferential statistics were applied to estimate knowledge and attitudes towards telesurgery among physicians and to identify factors associated with physician knowledge and attitudes towards telesurgery.

Study design
Cross-sectional study design.

Setting
This study was conducted at six specialised referral hospitals and two specialised and teaching referral hospitals in the Amhara region, northwest Ethiopia.

Result
408 physicians were included for analysis, with a response rate of 96.45%. Among study participants, 47.8% and 43.1% had good knowledge and attitudes towards telesurgery, respectively. Educational status, digital literacy, source of information, computer training, digital health training and internet access in the organisation were factors associated with a physician’s knowledge of telesurgery. Moreover, physician’s knowledge, technology use, educational status, computer training, computer access and internet access in the organisation were factors associated with physicians’ attitudes towards telesurgery.

Conclusion and recommendation
Almost half of physicians had good knowledge, and less than half had a good attitude towards telesurgery, so healthcare policy-makers should improve physicians’ digital literacy, technology use and internet access to enhance their knowledge and attitudes for future implementation.

Parte un progetto dell’Aou di Cagliari

Parte un progetto dell’Aou di Cagliari