Search Results for: Screening del cancro del colon-retto

Circulation, Ahead of Print. BACKGROUND:The somaticJAK2V617Fsequence variation, a key driver of myeloproliferative neoplasms, has been associated with increased risk of aortic aneurysms. This study aimed to explore associations between theJAK2V617Fvariant allele frequency (VAF) and ascending, descending, and abdominal aortic aneurysms.METHODS:In the DANCAVAS I and II trials (Danish Cardiovascular Screening), 15 000 individuals underwent cardiovascular risk assessments including blood samples and noncontrast ECG-gated computed tomography scans. In this cross-sectional substudy, individuals with screening-detected aortic aneurysms (≥45 mm ascending, ≥35 mm descending, or ≥30 mm abdominal), random aneurysm-free male controls, and all women (only included during the DANCAVAS I pilot study) were tested for theJAK2V617Fsequence variation.RESULTS:A total of 8056 individuals (90.9% men, mean age 68±4 years) were tested for theJAK2V617Fsequence variation, which presented an overall prevalence of 7.1%. Ascending, descending, and abdominal aneurysm prevalences were 6.6%, 2.9%, and 6.8%, respectively. InJAK2V617F-negative participants (n=7486),JAK2V617F-positive participants with VAF

Stroke, Ahead of Print. BACKGROUND:Aneurysmal subarachnoid hemorrhage (aSAH) causes a substantial proportion of all deaths among middle-aged people, especially women. Because female smokers in particular have a high risk of aSAH and subarachnoid hemorrhage deaths, targeted screening of 50- to 60-year-old female smokers could be justified as a preventive action to reduce premature deaths and morbidity.METHODS:This prospective screening study has been performed at Helsinki University Hospital in the Department of Neurosurgery in 2 phases during 2020 and 2023 to 2024. To minimize recruitment bias, the Helsinki Biobank and THL Biobank were responsible for sending out preliminary invitation letters to self-caring 50- to 60-year-old women (mean, 56 years) who were known to be active smokers. We informed the potential candidates about the study and answered any questions before their decision to participate. Once written consent was provided, participants filled in a detailed questionnaire on lifestyle and health, and underwent computed tomography angiography analysis. We studied the prevalence of unruptured intracranial aneurysms among the study participants. Moreover, we assessed immediate morbidity, mortality, and costs related to screening.RESULTS:Of the 458 preliminary invitation letters, 160 potential participants initially replied. Of these, 116 returned questionnaires and written consents. Ultimately, 108 smoking women underwent computed tomography angiography imaging. Eleven unruptured intracranial aneurysms were found in 11 (10%) female smokers, 1 of which was intracavernous and extradural. Two women were operated on without complications—1 with a middle cerebral artery aneurysm and 1 with a posterior communicating artery aneurysm. Most (n=8) patients with small (

Geriatri, ‘più screening e dispositivi monitor indossabili’

In Reply Health care systems vary considerably in terms of patient mix and clinical service structure. Therefore, it is unsurprising to observe wide variations in rapid response team activations (5 to 56 per 1000 admissions) and in the proportions of cardiac arrests (1 to 48.6 per 1000 admissions) and hospital mortality (0.2 to 49.1 per 1000 admissions). The proportions reported in the SCREEN trial and those reported by Drs Bellomo and Jones fall within these ranges. The sepsis alert was designed to identify clinically deteriorating patients early before meeting the rapid response team activation criteria. This explains why alerts occurred more frequently than rapid response team activations (14.6% compared with 4.8%). Therefore, rapid response teams should not be considered a replacement for systems for early identification of sepsis.

To the Editor In the Stepped-wedge Cluster Randomized Trial of Electronic Early Notification of Sepsis in Hospitalized Ward Patients (SCREEN) trial, the authors concluded that electronic sepsis screening compared with no screening reduced 90-day mortality in hospitalized patients. While the top-line conclusions are statistically valid, we would highlight 2 additional and related interpretations.

To the Editor A recent study reported improvement in patient outcomes observed with electronic alerts. However, we have some concerns about its generalizability to hospitals with well-established rapid response systems.

-37%rischio morte con esercizio fisico.Banditi cibi infiammatori

Circulation, Volume 151, Issue 22, Page 1547-1549, June 3, 2025.

New England Journal of Medicine, Ahead of Print.

Objective
To assess the appropriateness, acceptability and feasibility of implementing the Test-it PrCr Urinalysis Dipstick Test (LifeAssay Diagnostics, South Africa) in referral hospitals in Ghana.

Participants
96 healthcare professionals were trained on the protein-to-creatinine (PrCr) test, which was integrated into protocols alongside standard-of-care tests between November 2021 and April 2022. Test users completed questionnaires post training. Three focus group discussions (FGDs) and seven key informant interviews were conducted to evaluate test procedure comprehension, insights into training effectiveness, usability/user confidence, perceptions, attitudes towards the test and barriers and facilitators of use.

Results
High product usability, user confidence and satisfaction were reported. Staff perceived the test as easy to use and similar to current products. Misinterpretations of test results were less likely for strong results. Facilitators of use included effective trainings, sensitisation of the product and key stakeholder endorsement. Challenges impacting implementation feasibility included the short shelf life of test strips (3 months) after opening cannisters, the added complexity of the ratiometric result interpretation and the test’s lack of other parameters that are included in current products (eg, glucose, nitrate), limiting its broader clinical utility for antenatal care screening. All FGD participants agreed that the use of the PrCr test would not change current practices/protocols for dipstick use.

Conclusion
Although the Test-It PrCr test is easy to use and well accepted, key product attributes limit its implementation feasibility in this setting. It may be more appropriate for monitoring high-risk women in this context.

Objectives
To develop and validate an automated diabetic macular oedema (DME) classification system based on the images from different three-dimensional optical coherence tomography (3-D OCT) devices.

Design
A multicentre, platform-based development study using retrospective and cross-sectional data. Data were subjected to a two-level grading system by trained graders and a retina specialist, and categorised into three types: no DME, non-centre-involved DME and centre-involved DME (CI-DME). The 3-D convolutional neural networks algorithm was used for DME classification system development. The deep learning (DL) performance was compared with the diabetic retinopathy experts.

Setting
Data were collected from Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Chaozhou People’s Hospital and The Second Affiliated Hospital of Shantou University Medical College from January 2010 to December 2023.

Participants
7790 volumes of 7146 eyes from 4254 patients were annotated, of which 6281 images were used as the development set and 1509 images were used as the external validation set, split based on the centres.

Main outcomes
Accuracy, F1-score, sensitivity, specificity, area under receiver operating characteristic curve (AUROC) and Cohen’s kappa were calculated to evaluate the performance of the DL algorithm.

Results
In classifying DME with non-DME, our model achieved an AUROCs of 0.990 (95% CI 0.983 to 0.996) and 0.916 (95% CI 0.902 to 0.930) for hold-out testing dataset and external validation dataset, respectively. To distinguish CI-DME from non-centre-involved-DME, our model achieved AUROCs of 0.859 (95% CI 0.812 to 0.906) and 0.881 (95% CI 0.859 to 0.902), respectively. In addition, our system showed comparable performance (Cohen’s : 0.85 and 0.75) to the retina experts (Cohen’s : 0.58–0.92 and 0.70–0.71).

Conclusions
Our DL system achieved high accuracy in multiclassification tasks on DME classification with 3-D OCT images, which can be applied to population-based DME screening.

Objective
To understand the importance and potential impact on uptake of different attributes of risk-based innovations in the context of risk-stratified healthcare for cancer screening and symptomatic diagnosis.

Design
The online survey comprised a discrete choice experiment (DCE) in which participants chose between two risk assessment options or to opt out of risk stratification. There were six attributes: test method, type (genetic or non-genetic), location, frequency, sensitivity and specificity. Participants were randomly allocated to consider the choice in an asymptomatic or symptomatic context.

Setting
Members of the public in the UK.

Participants
1202 participants completed the DCE.

Outcome measures
Conditional logistic regression and latent class analysis informed modelling of predicted preferences for a range of innovations with different features.

Results
Overall, participants preferred risk assessments over opting out and prioritised sensitivity, with test method and specificity also important. Genetic and non-invasive tests were favoured. With sensitivity and specificity of 80% or better, participants would be more likely to take up a risk assessment than not. Comparing the asymptomatic and symptomatic contexts, 65% and 73% of participants would be very likely to participate regardless of the innovation used, and 29% and 13% of participants might participate depending on the method, sensitivity and specificity. A minority showed strong dislike of risk-based innovations, particularly within screening.

Conclusions
There are high levels of public support for risk-based innovations within risk-stratified cancer healthcare, especially for referral decision-making and using genetic and non-invasive tests. Optimising risk-based innovations is needed to engage those whose participation is contingent on test methods and performance metrics.

Objectives
This study aimed to investigate the prevalence of diabetes mellitus in patients with Fabry disease using a nationwide population-based dataset. We hypothesised that patients with Fabry disease would have a higher prevalence of diabetes mellitus compared with the general population.

Design
A cross-sectional study.

Setting
Taiwan.

Participants
We identified a study sample from Taiwan’s LHID2010 Database. There were 9408 sampled patients in this study, 2352 study patients with Fabry disease and 7056 propensity-score-matched comparison patients.

Primary outcome measures
Multiple logistic regression analyses were conducted to explore the association between diabetes mellitus and Fabry disease after taking the variables of age, sex, geographic location, monthly income category, urbanisation level of the patient’s residence, hyperlipidaemia and hypertension into consideration.

Results
The results revealed significantly higher prevalence of diabetes mellitus among patients with Fabry disease than among comparison patients (35.8% vs 29.6%, p

Con gene di Braf mutato. Combinazione allunga sopravvivenza

Objectives
Entrustable professional activities (EPAs) have been used in undergraduate and graduate medical education and in other health professions for a long time. They are regarded as a suitable way for bridging the gap between competency-based education and actual work tasks in the workplace. In nursing education, EPA development started later, and it is unclear which EPAs have been developed and implemented yet. This scoping review aims to identify which EPAs have been developed in nursing education, which of these have even been implemented and what the empirical evidence supports any effects of implementation.

Design
Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Data sources
MEDLINE and EMBASE via OVID, CINAHL and ERIC via EBSCOhost were searched for the period 1 January 1995 to 31 December 2023.

Eligibility criteria
Publication period from the first mention of EPAs in 1995 to 2023, no language restrictions, all types of literature if they had a clear mention of EPAs, all academic nursing education fields, EPAs had to be mentioned in the title or abstract.

Data extraction and synthesis
Screening was conducted in a two-stage process with two authors. 13 suitable articles were included which describe either the development, implementation or assessment of EPAs.

Results
Results indicated that EPAs have been developed in 16 areas of nursing education, including special areas such as palliative care or emergency/intensive care. The activities health status assessment, care measures, leadership/management, diagnoses, care plans and protocols, emergency care measures and participation in diagnostics and/or therapy were described most often. In 4 out of 13 cases, EPAs were implemented. Described evidence indicated that the use of EPAs improved critical thinking, promoted flexibility in teaching and led to a mindset change.

Conclusions
EPAs are increasingly developed and implemented in nursing education. There seem to be overlaps between EPAs mainly covering the steps of the nursing care process.