Risultati per: GPG: Versione 5.0 (25 Novembre 2019)

Annals of Internal Medicine, Ahead of Print.

Uberti: “Obiettivo è rafforzare il personale sanitario”

Sindacato: ‘Sos in 6 regioni. Stato di agitazione a Cagliari’

‘Davanti sfide complesse, da cambiamenti clima a nuovi alimenti’

Objective
Adolescence is a critical period characterised by significant biological growth and transformative changes in social relationships. No authoritative study has provided a comprehensive analysis of the global burden attributed to alcohol and drug use among adolescents and young adults.

Study design, participants and methods
Data on alcohol and drug use among people aged 10–24 years were extracted from the Global Burden of Disease Study 2019. We reported the trends of death and disability-adjusted life years (DALYs) at the global, regional and national levels. We explored the sex and sociodemographic index distribution of disease burden.

Primary outcome measures
DALYs and deaths.

Results
In 2019, the number of deaths attributed to alcohol use and drug use among people aged 10–24 years was 59 855 and 16 391, respectively. The numbers of DALYs attributed to alcohol use and drug use were 5.9 million and 4.1 million, respectively. From 1990–2019, the global DALYs rate caused by alcohol use exhibited a downward trend for both males and females. The DALYs rate attributed to drug use in females among people aged 10–24 years exhibited a downward trend, while the DALYs rate attributed to drug use in males among people aged 10–24 years exhibited an upward trend. Furthermore, the burden attributed to alcohol use and drug use was significantly higher in males than in females. Eastern Europe had the highest burden attributed to alcohol use, and High-income North America had the highest burden of drug use.

Conclusions
Alcohol and drug use remain an important risk factor that poses substantial challenges to adolescent health, particularly among males. Countries must develop effective health policies and implement targeted regulatory measures.

Objective
To determine wealth-based inequality and the dropout rate in the completion of the maternal continuum of care (CoC) in Ethiopia.

Setting
Ethiopian Demographic and Health Survey-2019.

Participants
Reproductive-age women (15–49 years) in Ethiopia.

Primary outcome
Completion of the maternal CoC services is the primary outcome. Maternal CoC is defined as a situation where women have at least four antenatal care (ANC) visits, deliver their babies at a health facility and receive at least one postnatal care service for both mother and newborn baby.

Methods
We analysed the 2019 Mini demographic and health survey data using STATA V.17. Multilevel logistic regression analysis was employed for the factors associated with the maternal CoC. The concentration index was used to measure equity.

Result
Overall, 24% (95% CI: 21.6 to 26.5) of women completed the maternal CoC. There was wealth-based inequality in the completion of maternal CoC in Ethiopia (concentration index: 0.25 (95% CI: 0.18 to 0.31, p≤0.001)), rural residents (concentration index: 0.15 (95% CI: 0.09 to 0.21, p≤0.001)) and urban residents (concentration index: 0.15 (95% CI: 0.05 to 0.26, p≤0.01)). Being an urban resident (adjusted OR (AOR)=1.59, 95% CI: 1.09 to 2.33), attaining secondary (AOR=1.67, 95% CI: 1.19 to 2.33) or higher education (AOR=1.93, 95% CI: 1.30 to 2.87) and early initiation of ANC (AOR=1.97, 95% CI: 1.61 to 2.41) were positively associated with the completion of maternal CoC. However, belonging to a pastoral region (Afar or Somali) (AOR=0.46, 95% CI: 0.28 to 0.77), belonging to the poorest (AOR=0.58, 95% CI: 0.37 to 0.92) or middle (AOR=0.62, 95% CI: 0.40 to 0.96) wealth quintile, not being informed about obstetric danger signs (AOR=0.54, 95% CI: 0.43 to 0.66) and blood pressure not being measured (AOR=0.53, 95% CI: 0.32 to 0.85) were negatively associated with maternal CoC.

Conclusion
We concluded that completion of the maternal CoC was low in Ethiopia. There was significant inequality in the completion of maternal CoC across wealth status, place of residence and educational status. Strategies and interventions that target the disadvantaged group of women are needed to improve the utilisation of maternal healthcare services. Tailored and multisectoral intervention considering women with poor or middle wealth, women in pastoralist regions and women with no information on obstetric danger signs improves the CoC practice in the country.

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The World Health Organization (WHO) reported that measles cases in the European region more than doubled from 2023 to 2024, reaching about 127 000—the highest number since 1997. The increase has been linked to a lack of vaccination coverage: half a million children across the region—which comprises 53 countries in Europe and central Asia—missed their first dose of the measles vaccine (MCV1) in 2023. Children aged 5 years or younger accounted for about 2 out of 5 cases of the highly contagious virus.

Objectives
The influence of short-term variations in blood pressure (BP) in acute stroke on clinical outcomes remains uncertain. Our study explores the relationship between BP variability (BPV) from stroke admission up to 72 hours and in-hospital and 1-year mortality.

Design
Retrospective observational cohort study.

Setting
Hamad General Hospital (HGH) a tertiary care stroke centre in Qatar.

Participants
2820 participants were initially included. After the exclusion of ineligible subjects, 2554 patients (82.5% male, median age 53±9 years) were included. 893 (34.96%) were from the Middle East and North Africa, 1302 (50.98%) were from South Asia, 258 (10.10%) from Southeast Asia, 9 (0.35%) were from East Asia and 92 (3.60%) were from other regions. Eligible participants were adult patients above 18 years of age who presented with acute ischaemic or haemorrhagic stroke. Excluded individuals were those younger than 18 years, had incomplete data, had transient ischaemic attack (TIA), had severe hypoglycaemia on admission (

Il sindacato degli ospedalieri, ‘non rispettati i contratti’

New England Journal of Medicine, Volume 392, Issue 19, Page 1941-1952, May 15/22, 2025.

100.000 pazienti trattati grazie a una rete di 8 centri

Stanno bene, per 24/enne cesareo urgenza in 28esima settimana

Objective
To analyse the trend of the disease burden of common malignancies of the female reproductive system and the influence of age, period and birth cohort in China from 1990 to 2019.

Design
We used the joinpoint model based on the global burden of disease (GBD 2019) database to explore the trend of the burden of common malignancies of the female reproductive system in China from 1990 to 2019, and further analyzed the impact of age, period, and birth cohort using the age-period-cohort model.

Setting
GBD data from 1990 to 2019.

Participants
Data were publicly available and individuals were not involved.

Main outcomes
Outcomes included age standardised incidence rate, standardised mortality, standardised disability-adjusted life year (DALY), annual percentage change, average annual percentage change, age (period, cohort) effect coefficient, relative coefficient and SE. Akchi information criterion and Bayesian information criterion were used to estimate model goodness of fit.

Results
From 1990 to 2019, the standardised incidence and prevalence of cervical cancer and endometrial cancer increased, while the standardised mortality and DALY rate decreased. The standardised incidence, prevalence, mortality and DALY rates of ovarian cancer increased. The risk of cervical cancer, ovarian cancer and endometrial cancer increased first and then decreased with age, reaching its peak at ages 55, 70 and 55, respectively, while the risk of death increased with age. The risk of the onset and death of cervical cancer and ovarian cancer increased with the period, while those of endometrial cancer increased first and then decreased. The cohort with later female reproductive system malignancies had a lower risk of morbidity and mortality than the previous cohort.

Conclusion
From 1990 to 2019, the disease burden of malignant tumours in the female reproductive system in China was high. Relevant departments should pay attention to the prevention and treatment of malignant tumours in the reproductive system. Middle-aged and elderly women are the key target group for prevention and control.

Esempio virtuoso di integrazione sanitaria pubblico-privata