Search Results for: I numeri del cancro in Italia 2019

Stroke, Ahead of Print. BACKGROUND:Carotid web is a rare and likely underrecognized cause of ischemic stroke, particularly in young patients. Given the high risk of recurrence, diagnostic delays may have serious consequences. This study aimed to assess the incidence and impact of delayed carotid web diagnosis after a first ischemic event.METHODS:We conducted a retrospective analysis using data from the French ongoing multicenter prospective CAROWEB (Carotid Web registry). We included patients with a first-ever ischemic stroke or transient ischemic attack in the anterior circulation, attributed to an ipsilateral carotid web with no other identifiable cause, between September 2013 and April 2023. Patients with missing data on the date of the first ischemic event or carotid web diagnosis, or with prior stroke history, were excluded. Participants were categorized into early diagnosis (≤30 days) and delayed diagnosis ( >30 days) groups. Factors associated with diagnostic delay were investigated through univariable and multivariable analyses. Stroke recurrence was evaluated using Kaplan-Meier survival analysis.RESULTS:Of 280 patients in the registry, 225 met the inclusion criteria. A delayed diagnosis occurred in 57 patients (25.3%). Independent predictors of diagnostic delay included lower initial National Institutes of Health Stroke Scale score (odds ratio, 0.92;P=0.002), stroke occurring before 2019 (odds ratio, 0.19;P

Oltre 20 mila volontari in quasi 4 mila piazze d’Italia

Soi, in Italia un terzo delle procedure rispetto a Francia e UK

Cnt, sopravvivenza a 10 anni 80%, in lista attesa 64% uomini

Ultimo a Barletta da un 89enne. Record mondiale in Italia a 100 anni

L’incidenza di certi tumori più alta rispetto ai coetanei maschi

Background
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. The combination of tremelimumab and durvalumab is now a standard treatment option for advanced HCC.

Objective
To study immune responses in HCC patients treated with tremelimumab and durvalumab.

Design
We treated 28 HCC patients with durvalumab, tremelimumab and locoregional therapies. We performed a high-dimensional multiomics analysis including whole exome sequencing, single-cell RNA seq, CO-Detection by indEXing, flow cytometry and multiplex cytokine/chemokine analysis of patients’ blood and tumour samples and integrated this data to elucidate immune correlatives and response mechanisms. Mice with syngeneic HCC were treated with anti-PD-L1 plus anti-CTLA4 for hepatic lymphocytes, tumour-infiltrating lymphocytes and peripheral blood mononuclear cell analysis.

Results
The median overall survival was 19.2 months. Tumour tissue analysis revealed enhanced interferon responses, with stronger effects in responders. Gene set variation analysis indicated enhanced antigen presentation in responders. Spatial analysis revealed that non-responder tumours had higher numbers of Tregs located in neighbourhoods enriched with immune cells and expressed higher levels of ICOS and PD-1. Conversely, non-responder PD1+CD8+T in these Treg-enriched neighbourhoods expressed lower ICOS. Cell-communication analysis demonstrated that Treg-CD8+T interaction was enhanced in non-responder tissue. Peripheral blood analysis showed increased classical monocytes in responders and Tregs in non-responders. Treg-CD8+T interaction was confirmed in preclinical models. Finally, single-patient computational analysis from the all-across analysis was performed on 860 features, which led to the identification of multiomics feature sets including Treg features.

Conclusion
Our study provides a blueprint for in-depth analysis of immune correlates in immunotherapy studies and demonstrates the importance of Treg distribution in HCC.

Trial registration numbers
NCT02821754 and the EudraCT identifier: 2019-002767-98.

Background
A large proportion of individuals with coeliac disease (CeD) remain undiagnosed.

Objective
The aim of this study was to assess serological screening for CeD in the adult general population.

Design
The study was based on the fourth Trøndelag Health Study, a population-based study performed 2017–2019 in Nord-Trøndelag County, Norway, including 56 042 participants >20 years of age (54% participation rate). Serum samples were analysed with a dual antitransglutaminase 2 (TG2) IgA and IgG assay and seropositive participants were invited to endoscopy with duodenal biopsies. A CeD diagnosis was given if mucosal damage (Marsh grade 3) was found.

Results
Histological evaluation of 657 seropositive participants confirmed CeD in 423. The positive predictive value (PPV) of a positive TG2 IgA was 73.3% (95% CI 69.7% to 77.0%) for biopsy-confirmed CeD. TG2 IgA ≥10 times the upper limit of normal (ULN), as used in the no-biopsy approach in children, increased the PPV to 88.1% (95% CI 84.8% to 91.4%). Primary TG2 IgG response was found in 87 participants, five of whom had biopsy-confirmed CeD. One of the participants with CeD primarily responding with TG2 IgG was IgA deficient. The PPV of a positive TG2 IgG was 5.8% (95% CI 1.9% to 12.9%) and of TG2 IgG ≥10x ULN was 9.5% (95% CI 1.2% to 30.4%) for biopsy-confirmed CeD in TG2 IgA-negative individuals.

Conclusion
The TG2 IgA assay showed excellent abilities as a screening tool for CeD in the adult general population. However, the diagnostic accuracy of TG2 IgG was too poor for selectively identifying individuals with CeD.

Oltre 20 mila volontari in quasi 4 mila piazze d’Italia

Idrocefalo normoteso, malattia curabile ma poco nota. Possibili fino a 35 miliardi di euro di risparmio in un anno per il Servizio sanitario nazionale

Objectives
Patients undergoing revision total knee replacement (RevKR) surgery often have difficulties mobilising and increasingly rely on family support. Evolving practice in England aims to manage these patients in specialised centres with the intention of improving outcomes. This practice will result in longer travel distances and times in this frailer group of patients. We want to examine the types of distances and travel times patients can be expected to travel for this complex orthopaedic surgery and to explore concerns of how these impact patient outcomes.

Design
Retrospective observational study from the Hospital Episode Statistics. Multivariable adjusted logistic regression models were used to investigate the relationship between patient travel distances and times with perioperative outcomes.

Setting
Patients presenting to tertiary referral centres between 1 January 2016 and 31 December 2019. A tertiary referral centre was defined as a trust performing >49 revisions in the year prior.

Participants
Adult patients undergoing RevKR procedures for any reason between 1 January 2016 ando 31 December 2019.

Exposure
The shortest patient level travel distance and time was calculated using the Department of Health Journey Time Statistics using Transport Accessibility and Connectivity Calculator software and Dijkstra’s algorithm.

Main outcome measures
The primary outcome is emergency readmission within 30 days. Secondary outcomes are mortality within 90 days and length of inpatient stay.

Results
6880 patients underwent RevKR at 36 tertiary referral centres. There was a weak correlation between social deprivation and travel distance, with patients from the most deprived areas travelling longer distances. Overall, 30-day readmission was not statistically associated with longer driving distance (OR 1.00 95% CI 0.99 to 1.02) or peak driving times (OR 1.00 95% CI 0.99 to 1.01).

Conclusions
There was no association between increasing travel distance and time on perioperative outcomes for RevKR patients.

Nella Penisola oltre 16 milioni, in Usa 26 mila morti

Report Assalco, riducono del 15% le visite mediche negli anziani

In Italia ne soffrono circa 40mila persone, soprattutto donne

Stroke, Ahead of Print. BACKGROUND:Stroke survivors are highly sedentary and engage in minimal physical activity. This study aimed to investigate the independent and joint effects of daily sitting time and leisure-time physical activity on survival among stroke survivors.METHODS:The nationally representative cohort included 1446 stroke survivors (weighted population, 6 968 723) from the National Health and Nutrition Examination Survey from 2007 to 2018. Mortality data were obtained through December 31, 2019. Leisure-time physical activity was categorized as inactive (0 min/wk), insufficiently active (1 to

Objectives
To systematically assess the robustness of meta-analyses based on randomised controlled trials (RCTs) in vascular surgery using the Fragility Index (FI).

Design
Cross-sectional study.

Setting
Meta-analyses published in English from January 2019 to April 2025, identified from EMBASE, PubMed and Web of Science.

Participants
67 articles, with 291 meta-analyses involving RCTs evaluating vascular surgical interventions, covering venous, aortic, peripheral arterial, vascular access and other relevant fields.

Main outcome measures
FI, defined as the minimum number of event changes required to alter the statistical significance of meta-analysis results, and its association with sample size and total number of events, analysed using frequency distribution histograms and restricted cubic spline models.

Results
The median FI was 7, with considerable variation across different fields. Aortic meta-analyses demonstrated higher robustness compared with venous and vascular access meta-analyses. FI showed a non-linear relationship with sample size and total number of events, indicating robustness improved only up to specific thresholds, beyond which robustness declined or plateaued.

Conclusion
Overall robustness of meta-analyses in vascular surgery was moderate, with notable variability among research areas. FI provides valuable insight into the stability of synthesised evidence, suggesting the need for improved methodological quality and advocating broader adoption of FI in meta-analytical research.