Antibiotico-resistenza, da Bari la rivoluzione della diagnosi rapida per limitare le infezioni in ospedale [Infettivologia]

Antibiotico-resistenza: ogni anno, circa 200mila persone in Italia sono colpite da infezioni causate da batteri resistenti agli antibiotici. Ma solo il 5% dei pazienti ospedalizzati con infezioni respiratorie riceve una diagnosi corretta attraverso un esame di laboratorio che identifichi il patogeno responsabile, confondendo così infezioni virali e batteriche. Da Bari viene rilanciata la rete nazionale per potenziare la diagnostica microbiologica, con l’obiettivo di frenare un’emergenza sanitaria globale che costa vite, allunga le degenze e aumenta i costi per il sistema sanitario.

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MASLD e MASH: resmetirom e agonisti del recettore del glucagone testa a testa per efficacia [Gastroenterologia ed epatologia]

Nei pazienti affetti da steatosi epatica metabolica (MASLD) o steatoepatite metabolica (MASH), sia il resmetirom che gli agonisti del recettore del glucagone hanno dimostrato di ridurre significativamente il grasso epatico e i livelli di alanina aminotransferasi (ALT), secondo quanto emerso da una metanalisi presentata all’ENDO 2025, congresso dell’Endocrine Society.

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Artrite psoriasica, studio APEX: guselkumab determina una significativa inibizione del danno strutturale #EULAR2025 [Ortopedia e Reumatologia]

Guselkumab, somministrato ogni 4 (Q4W) o 8 settimane (Q8W), ha dimostrato una “significativa inibizione” del danno strutturale nei pazienti con artrite psoriasica (PsA) attiva. Questo il messaggio principale proveniente dallo studio di fase 3b APEX, presentato al congresso EULAR a Barcellona da Philip J Mease, professore e direttore della ricerca reumatologica presso lo Swedish Medical Center a Seattle, negli Usa.

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Antibiotici in gravidanza: rischio malformativo associato al trimetoprim-sulfametossazolo nel primo trimestre [Infettivologia]

Le infezioni delle vie urinarie (IVU) rappresentano una delle complicanze infettive più frequenti durante la gravidanza, sia nella forma di batteriuria asintomatica che di cistite acuta. Entrambe le condizioni, se non trattate, possono favorire esiti avversi perinatali, ma il primo trimestre di gestazione è una fase estremamente delicata per lo sviluppo fetale, in cui l’esposizione a farmaci potenzialmente teratogeni può aumentare il rischio di malformazioni congenite. In questo contesto, l’uso di antibiotici deve bilanciare attentamente i benefici per la madre con i possibili rischi per il nascituro.

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Randomised controlled trial comparing low doses of aspirin in the prevention of pre-eclampsia (ASAPP): a study protocol

Introduction
Pre-eclampsia (PEC) is a morbid and potentially lethal complication of pregnancy and is more common in women with risk factors such as hypertension, diabetes, autoimmune disease, kidney disease or multifetal pregnancies. Low dose aspirin (ASA) is currently the only prophylactic therapy known to decrease PEC in this patient population. However, currently, there is no prospective literature comparing various low-dose ASA formulations in the risk reduction of PEC. In the USA, the currently available low-dose ASA is over-the-counter and found in 81 mg tablets. Therefore, when clinicians initiate low-dose ASA therapy, they may prescribe one or two tablets of 81 mg per day without comparative evidence to guide their decision. Our objective is to prospectively compare pregnant patients on 81 mg vs 162 mg of ASA and determine a possible dose response in the prevention of PEC.

Methods and analysis
We designed a pragmatic phase 3 prospective randomised open label blinded-end point clinical trial with parallel assignment between two groups of pregnant people at high risk for PEC, as defined by the US Preventive Services Task Force and American College of Obstetricians and Gynecologists (ACOG). The primary outcome is the incidence of preterm (

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Impact of vaccine mandates and removals on COVID-19 vaccine uptake in Australia and international comparators: a study protocol

Background
Vaccination against SARS-CoV-2 was a crucial public health measure during the COVID-19 pandemic. Among the multiple strategies developed to increase vaccine uptake, governments often employed vaccine mandates. However, little evidence exists globally about the impact of these mandates and their subsequent removal on vaccine uptake, including in Australia, France, Italy and the USA. The aim of this study is to provide a protocol to evaluate and quantify the impact of COVID-19 vaccine mandates and removals on vaccine uptake in these countries, with a specific focus on comparing Australian policies with those from Europe and the USA. Actualising the work outlined in this protocol will help to provide policy and technical guidance for future pandemic preparedness and routine immunisation programmes.

Methods and analysis
This protocol outlines a retrospective study using existing data sources including Australian Immunisation Register-Person Level Integrated Data Asset for Australia and publicly available data for France, Italy and California (USA). Causal inference methods such as interrupted time series, regression discontinuity design, difference-in-differences, matching and synthetic control will be employed to assess the estimated effects of vaccine mandates and removals on vaccine uptake.

Ethics and dissemination
The University of Newcastle’s human research ethics committee has approved the study (reference number: H-2024-0160). Peer-reviewed papers will be submitted, and results will be presented at public health, immunisation and health economic conferences nationally and internationally. A lay summary will be published on the MandEval website.

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Insights and interventions for improving cultural humility towards Asian American, Native Hawaiian and Pacific Islander populations in medical curricula: a qualitative case study

Objectives
The Asian American, Native Hawaiian and Pacific Islander (AANHPI) community is the fastest-growing racial/ethnic population in the USA. Previous research identified that medical students perceived a lack of exposure to AANHPI patients and topics in medical school curricula; however, there remains a lack of potential interventions to address this need. The goal of our study is to present a case study for identifying interventions in medical school curricula that improve cultural humility-based training for providing medical care for AANHPI populations.

Design
In this qualitative study, authors conducted four virtual focus groups with 15 medical students at a single institution to identify curricular interventions. The authors then conducted virtual semistructured interviews with eight medical educators one-on-one to explore the feasibility of the proposed interventions. Data were analysed using qualitative thematic analysis, and analysis was performed with ATLAS.ti.

Setting
Medical students and medical educators based at medical institutions in the USA.

Participants
15 medical students and eight medical educators participated in the study.

Results
All medical students (n=15) and educators (n=8) noted that there is limited engagement of AANHPI communities in current medical curricula and limited curricular components that address the diversity within the AANHPI umbrella. Medical student focus groups identified three interventions to improve cultural humility-based training for treating AANHPI patients: reflection spaces, community engagement and clinical training on documenting cultural needs. Educators supported the feasibility and importance of these interventions to prepare students to work with not only AANHPI patients but also with patients of other diverse backgrounds.

Conclusion
AANHPIs represent a heterogeneous population consisting of unique cultural heritages. Our research demonstrates the importance of highlighting this community in cultural humility curricula to provide an example of how to consider and appreciate diversity in patient populations. In this paper, we present student and medical educator-supported curricular interventions that not only increase awareness of issues impacting AANHPI communities, but also emphasise building skills of self-reflection, lifelong learning and empathy that are applicable to patients of all backgrounds.

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