Search Results for: Atlante della salute mentale 2011

Stroke, Ahead of Print. BACKGROUND:The efficacy of minimally invasive surgery (MIS) in improving outcomes after nontraumatic intracerebral hemorrhage (ICH) remains uncertain, with inconsistent findings from randomized clinical trials. Our objective was to evaluate the real-world impact of MIS on ICH outcomes using a nationally representative cohort.METHODS:We performed a retrospective cohort study of patients with a nontraumatic ICH enrolled in the American Heart Association Get With The Guidelines-Stroke Registry between January 1, 2011, and December 31, 2021. We excluded patients with a diagnosis of ischemic stroke or other intracranial hemorrhage subtypes, those who underwent open craniotomy or craniectomy, and patients transferred to another hospital. The exposure was MIS, defined as a composite of stereotactic surgical evacuation and endoscopic surgical evacuation. The primary outcome was in-hospital mortality, while secondary outcomes included functional outcomes at discharge (discharge disposition, ambulatory status, and modified Rankin Scale score). We matched patients who underwent MIS with nonsurgical patients using overlap propensity matching and used multiple logistic regression to study the association between MIS and outcomes.RESULTS:Among 684 467 patients with ICH, 555 964 were included; the mean age was 68 (SD, 15.3) years, and 262 999 (47.3%) were female. MIS was performed in 703 patients of whom 312 had stereotactic surgery and 391 had endoscopic surgery. In the matched cohort, in-hospital deaths occurred in 60 of 446 (13.5%) with MIS and 8321 of 35 361 patients (23.5%) without surgery. In regression analyses, MIS was associated with lower in-hospital mortality (adjusted odds ratio, 0.50 [95% CI, 0.39–0.65]) and favorable discharge disposition (adjusted odds ratio, 1.93 [95% CI, 1.61–2.32]) but not with ambulatory status or functional outcomes. In additional analyses, stereotactic surgery and endoscopic surgery were independently associated with lower mortality.CONCLUSIONS:In a large diverse cohort of patients with ICH, MIS was associated with lower in-hospital mortality and favorable discharge disposition. These findings support efforts to understand the durable impact of MIS in patients with ICH.

Objective
Our study explored the association between depressive symptoms and non-fatal cardiovascular disease, as well as other significant risk factors for non-fatal cardiovascular disease, in middle-aged and elderly patients with hypertension in China.

Design
Prospective cohort study.

Setting
Data were sourced from the China Health and Retirement Longitudinal Study (CHARLS) database over a 9-year period (2011–2020).

Participants
Middle-aged and elderly patients with hypertension aged 45 and above in China.

Outcome measures
Non-fatal cardiovascular disease was ascertained based on self-reported, physician-diagnosed heart disease. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale-10.

Results
A total of 1755 participants were enrolled in the prospective cohort study. The incidence of non-fatal cardiovascular diseases among patients with hypertension was 5 per 1000 person-months. There was a positive linear correlation between depressive symptoms and the risk of non-fatal cardiovascular diseases (pnon-linear=0.625). Meanwhile, an inverted U-shaped relationship was identified between baseline duration of hypertension and risk of non-fatal cardiovascular diseases; those experiencing hypertension for 15 years had the highest risk, with the risk decreasing for durations above or below this value (pnon-linear

Durante la tappa fidardense dell’iniziativa Incra-Croce rossa

In 10 anni risparmiati 2,2 miliardi ma con effetti sulla salute

“Biologicamente è possibile invecchiare restando in salute”

“Biologicamente è possibile invecchiare restando in salute”

Progetto della Città della Salute e del Politecnico di Torino

Saltamartini, ‘Promuoviamo corretti stili di vita tra i giovani’

Stroke, Ahead of Print. BACKGROUND:Modifiable risk factors play a central role in the development and course of neurodegenerative disorders of later life, including dementias. Although past research has focused on independent associations of modifiable risk factors, including cardiovascular disease risk factors using Framingham cardiovascular risk score, physical activity, dietary quality, body mass index, and sleep, on neurodegeneration, the impact of all 5 factors simultaneously in a multimodal model has not been studied. We examined independent associations and an overall combined model with 5 modifiable risk factors with white matter injury, a recognized risk factor for dementia, ≈10 years later in a diverse Hispanic/Latino population.METHODS:Participants were from the HCHS/SOL (Hispanic Community Health Study/Study of Latinos)-Magnetic Resonance Imaging longitudinal study (n=2667; clinical visit 1 mean age, 52.01 [8.90] years). We conducted path and mediation analyses across 5 modifiable risk factors obtained at clinical visit 1 (2008–2011) and 2 measures of white matter injury (free water and white matter hyperintensity volume) obtained at the magnetic resonance imaging visit (2018–2022; mean age, 62.37 [9.23] years). We controlled for age at the time of the dependent variable was measured, sex, education, Hispanic/Latino heritage, overall cognitive status, and b-value when free water was included.RESULTS:We observed 11 significant independent associations across modifiable risk factors and white matter injury measures. The association of Framingham cardiovascular risk score to white matter hyperintensity volume was mediated by free water (indirect mediation: β=2.473; SE=0.207;P

Prima in Italia, finanziata dal ministero della Salute

Città della salute e della scienza: “Emergenza senza precedenti”

Ad aprile gli esiti del Tavolo interministeriale Salute-Famiglia

‘Serve fare di più per la salute degli italiani’

Ductal carcinoma in situ (DCIS) is considered a nonobligate precursor of invasive breast cancer. Surgery is thought to reduce this risk, as evidenced by studies demonstrating cause-specific survival of 97% to 98% after treatment with mastectomy or lumpectomy with or without radiotherapy. Invasive cancer is found at surgical excision in 26% of all women diagnosed with DCIS by core biopsy and in 20% of those with low- to intermediate-grade DCIS or lesions of 2 cm or smaller on mammography. Despite the apparent success of surgery, significant concerns about overtreatment of DCIS have been raised. The substantial increase in the detection of DCIS between 1992 and 2011 that coincided with the widespread adoption of screening mammography did not result in parallel reductions in invasive cancer detection or breast cancer mortality, suggesting that a proportion of the DCIS being identified would have never progressed to invasive cancer. The very high cause-specific survival after surgery and the limited knowledge of the evolution of untreated DCIS raises the possibility that similar excellent outcomes might be obtained with a less aggressive approach such as active monitoring, with surgery reserved for patients showing evidence of progression to invasive cancer; however, the safety of this approach is uncertain. Ideally, a subset of DCIS patients at low risk of progression to invasive cancer could be identified by molecular profiling, but at present, this goal remains aspirational.

Comunicato del 13/03/2025 n°10