Search Results for: Libro sugli antibiotici del WHO AWaRe (Access, Watch, Reserve)

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.

Circulation, Ahead of Print. BACKGROUND:Neurodevelopmental and functional impairments are among the most consequential morbidities for survivors of hypoplastic left heart syndrome after staged single ventricle surgical palliation. The SVRIII trial (Long-Term Outcomes of Children With Hypoplastic Left Heart Syndrome and the Impact of Norwood Shunt Type) enrolled adolescents, who were randomized to different surgical shunt types at the time of Norwood procedure as neonates, for multifaceted in-person evaluation. This study reports their neurodevelopmental outcomes.METHODS:Transplant-free survivors from SVRIII were invited to complete an in-person comprehensive neurodevelopmental evaluation in early adolescence. Outcomes across domains of cognition, academics, learning, memory, and attention, as well as social, emotional, behavioral, adaptive, and executive function, were compared with those of normative populations. Associations with demographic and medical covariates, including Norwood shunt type, were also assessed.RESULTS:Among 549 participants enrolled in the SVR trial (Single Ventricle Reconstruction), 200 of the 237 SVRIII participants (84%) completed a neurodevelopmental evaluation at a mean age of 11 years (range, 10 to 14 years). SVRIII participants who did versus did not undergo evaluation were more likely to be male (63% versus 51%), to be White (87% versus 76%), and to have a higher Childhood Opportunity Index score (61±26 versus 46±39). Full-scale intelligence quotient (88±18) was significantly lower than in the normative population, with 39% >1 and 15% >2 SD below the normative mean. Similar patterns were seen for reading (38% >1 SD and 16% >2 SD below the normative mean) and math (38% >1 SD and 19% >2 SD below the normative mean) scores. Attention, executive functioning, social development, visual memory, and adaptive functioning were all more impaired than in the normative population. Measures of socioeconomic status, number of medical complications, and requirement for a gastrostomy tube were each independent predictors of neurodevelopment, with socioeconomic status the most consistently significant factor across models. Group differences by shunt type were inconsistent across neurodevelopmental domains without a clear benefit of one surgical strategy.CONCLUSIONS:In early adolescence, transplant-free survivors of surgical palliation for hypoplastic left heart syndrome show concerning impairments across all domains of neurodevelopment. The distribution of affected outcomes is broad and associated with demographic, medical, and, most frequently, socioeconomic factors. Our findings support recommendations for neurodevelopmental evaluation during adolescence to guide individualized interventions to promote educational success and psychosocial well-being.REGISTRATION:URL:https://www.clinicaltrials.gov; Unique identifier: NCT02455531.

Contro malattie che rialzano la testa ‘usare bene antibiotici’

More than 60% of patients discharged from intensive care suffered at least one fall, and ≈25% suffered injurious falls.

The RCOG World Congress 2025 took place at the London ExCeL Centre on June 23–25, hosting over 2500 delegates from around 100 countries and delivering over 70 sessions with more than 220 global speakers. Under the theme of “Equity in care, innovation in action”, the programme covered an impressive range of topics, relevant to both UK and global audiences, including women’s health (eg, menopause, sexual health, inequalities in access to care, cancer, endometriosis, vulval disease, human papillomavirus (HPV) vaccination, and imaging in gynaecology), fertility and reproduction (eg, developments in assisted reproduction, abortion, and contraception), and pregnancy and post-partum care (eg, preterm birth, obstetric fistula, foetal imaging, and postpartum complications), as well as the emerging role of artificial intelligence (AI) and digital health across these topics.

New research suggests that people who frequently smoke marijuana or consume tetrahydrocannabinol (THC) edibles may be at risk of vascular endothelial dysfunction.

Following 3 years of negotiations, member states of the World Health Organization (WHO) recently announced adoption of the first-ever international pandemic agreement.

This Viewpoint explores the unique challenges of treating patients who are incarcerated, particularly amid the decentralization of California’s death row.

This Viewpoint explores how a US Food and Drug Administration Risk Evaluation and Mitigation Strategy on mifepristone limited access to medication abortion despite its long-standing history of safety and efficacy.

As the frontiers of health care expand, research published in medical journals like JAMA often features large-scale, international, multicenter trials and far-reaching topics, such as genomics and artificial intelligence. However, the need for individual participants to constitute vast datasets remains foundational. Tapping poetry’s capacity for expressing the uniqueness of voice and engendering empathy, the poem “Death equals one” invites readers to reflect on what makes scientific inquiry so valuable by doing something that it intentionally does not: humanize a piece of data. The poem depicts a lone epidemiologist as she studies a data point. She fixates on this “single line in the database,” initially seeing it as merely helpful information for her research. As we read, however, poetry allows us to learn more about who this data point actually is. In this poetically informed, unmasked world, both we and the speaker are humanized also. Vivid details like “never a math person” and “frail silhouette” breathe life into a person in our minds beyond “a mere string of figures.” Our materializing image of this multidimensional, not-so-hypothetical participant further contrasts with the simple equation comprising the poem’s title. The poem challenges us to remember the human beings behind the data points that we code, analyze, read, or write about. Here, poetry, in perhaps the unlikeliest of places, serves as a humbling reminder that each study participant entrusts a piece of themselves to us, to be safely and anonymously, and yet indelibly, “one among thousands” in the pursuit of inspired science.

This Viewpoint examines US states’ attempts to address the consequences of abortion bans by clarifying them in various ways, a form of legislative interference that further limits access to reproductive health care.

Una corsia preferenziale per chi fa ricerca sui preziosi antibiotici fondamentali per combattere i nuovi super batteri, ma anche priorità a chi decide di fare la ricerca clinica e preclinica…

Stroke, Ahead of Print. BACKGROUND:The PASSIoN study (Perinatal Arterial Stroke Treated With Stromal Cells Intranasally) demonstrated the feasibility and short-term safety of single-dose allogeneic mesenchymal stromal cells (MSCs) administered intranasally to neonates with perinatal arterial ischemic stroke between February 2020 and April 2021. In this study, we assessed long-term safety and neurodevelopmental outcomes and explored outcome differences with a non–MSC-treated cohort.METHODS:In this post hoc analysis, we evaluated the safety of MSC administration by assessing brain tissue loss, adverse events, and neurodevelopmental outcomes of PASSIoN participants (n=10). The tissue loss ratio was calculated using semi-automatic segmentation based on neonatal and 3-month magnetic resonance imaging. At the age of 2 years, we assessed the occurrence of cerebral palsy, motor and cognitive delays (Zscore

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.

This study highlights the significant burden of RSV in Asia, particularly among young children, and highlights substantial variation in seasonality and economic impact across the region. The findings emphasize the need for region-specific RSV data to inform targeted prevention strategies and healthcare resource allocation. High heterogeneity in cost estimates suggests variability in healthcare access and economic conditions, warranting further investigation.

Objective
During the COVID-19 pandemic, many clinical trials were conducted to identify effective COVID-19 therapeutics. However, while a large amount of resources was invested and significant numbers of patients participated, this did not necessarily have an impact on clinical practice. To face these issues, initiatives such as the 100 Days Mission have been set out globally. Yet, limited data exist on the context surrounding the implementation of clinical trials at a national level during a health emergency. The study explored experiences and perceptions of principal investigators in conducting clinical trials for COVID-19 therapeutics in Japan.

Design
A qualitative study was conducted using semistructured interviews. The obtained data were inductively analysed using thematic analysis.

Setting and participants
We interviewed 15 principal investigators between September and November 2022 who conducted investigator-initiated clinical trials on the development of COVID-19 therapeutics in Japan.

Results
Three themes were generated: structural barriers, fragmented efforts and limited evidence generation. Structural barriers and fragmented efforts comprised four subthemes: individual, institutional, interinstitutional and policy/regulatory levels. Structural barriers at all levels included (1) limitations of individual capabilities, (2) the double burden of clinical practice and research, (3) inefficient interinstitutional collaboration and (4) regulatory frameworks and available resources that interrupt stakeholders’ actions, leading to limited evidence generation despite the fragmented efforts of principal investigators and other stakeholders.

Conclusions
This study illustrated that the efforts of Japanese principal investigators did not necessarily pay off in identifying therapeutics. A strategic and systematic approach for an improved national clinical trial ecosystem must be sought during the interpandemic period to overcome structural barriers in harmonisation with the global stakeholders.