Risultati per: Nota 31

Circulation, Volume 150, Issue Suppl_1, Page A4146702-A4146702, November 12, 2024. Background:Aortic aneurysm, a potentially life-threatening condition characterized by weakness of the aortic wall, poses a significant health risk, especially when concurrent with high systolic blood pressure. In an aging population experiencing the effects of smoking and atherosclerotic disease, it is imperative to explore the burden associated with hypertension-related aortic aneurysm mortality.Methods:The Global Burden of Diseases (GBD) study was used to extract data for high systolic blood pressure-related aortic aneurysm from 1990-2021. Dataset was stratified globally, continent wise, and by World Bank income levels. Age-standardized death rates (ASDRs), disability-adjusted life years (DALYs), and years of life lost (YLL) were examined. Jointpoint regression was used to quantify these estimates and calculate average annual percentage changes (AAPCs).Results:Globally, the age standardized death rates (ASDR) for hypertension-related aortic aneurysm rupture had a declining trend from 1990-2021. In 1990, the ASDR was 0.52 (95% UI 0.39-0.65), which declined to 0.32 in 2021 (AAPC=-1.53; 95% CI -1.57 to -1.48). The disability-adjusted life-years (DALYs) were 9.55 in 1990 and decreased to 6.19 in 2021 (AAPC=-1.38; 95% CI -1.42 to -1.33). The age standardized years of life lost (YLL) also showed a uniform drop over the same period (AAPC=-1.38; 95% CI -1.42 to -1.33). In continent wise analysis, North America and Europe exhibited significant decline [(AAPC=-2.44; 95% CI -2.48 to -2.40) and (AAPC=-1.58; 95% CI -1.64 to -1.51) respectively], while Africa showed minimal variation. Importantly, however, Asia was the only continent with a rising mortality during this period (AAPC=0.77; 95% CI 0.73-0.81). According to World Bank income levels, high income countries had continuous decline in death rates while lower-middle income countries had increasing deaths rates. Upper-middle and low-income countries both had minimal variation in death rates during this period.Conclusion:Global efforts to reduce hypertension-related aortic aneurysm mortality have yielded positive results, but regional disparities persist. Continued research, prevention, and healthcare interventions are crucial to further mitigate this health risk.

New England Journal of Medicine, Volume 391, Issue 14, Page 1343-1354, October 10, 2024.

This observational study evaluates the predictive value of serological biomarkers with transepidermal water loss and hydration rate and the development of atopic dermatitis in infants.

Nursing Up: “Mai così tante.In nessun ospedale agenti dopo le 24”

Conducting qualitative research in marginalised communities is difficult and can be ethically challenging. In the context of public health, marginalised communities who disproportionately suffer from discrimination on the basis of different identity markers such as socio-economic class, disability, religion, race, and ethnicity may distrust public health institutions. Historical patterns of systemic discrimination and exclusion by governments can also create an environment of institutional distrust. This distrust is heightened during times of crisis, such as the COVID-19 and cost-of-living crisis.My research explores the experiences of older minority ethnic people in the United Kingdom through and after the COVID-19 pandemic. Conducting this research in times of crisis creates its unique set of methodological challenges and ethical questions. Finding solutions to the specific methodological and ethical challenges of engaging marginalised communities in qualitative research during times of crisis is vital, because research into these communities at such pivotal times offers important information that can be of use in future (health, environmental, etcetera) crises.This live presentation aims to discuss how I navigated these challenges throughout my qualitative research. This is done by elaborating on the choice of qualitative research methods in relation to the particularity and vulnerability of the respondents as older minority ethnic people, a critical reflection on how to ensure that their agency and perspective is centred, and a discussion of the role of my positionality as a Black migrant woman conducting research into this topic with these respondents. Lastly, as older minority ethnic people are at the intersection of multiple grounds of discrimination, this can offer a unique set of challenges for qualitative researchers who wish to centre this demographic in research. Hence, some of the reasons leading to the hesitation of older minority ethnic people in the UK for engaging in qualitative research related to crisis are explored.

Stroke, Volume 55, Issue Suppl_1, Page A31-A31, February 1, 2024. Introduction:Stroke patients often require complex post-discharge management in an outpatient setting. At this Comprehensive Stroke Center, stroke patients are to receive a 30-day, 90 day, and 1 year follow up with the stroke clinic. Post-acute follow up appointments are typically established after discharge, leading to scheduling delays for the 30-day appointment, patients lost to follow up, or no showing to appointments. Stroke Navigators are an emerging role that can bridge the gap between acute and post-acute care settings and integral to ensuring stroke patients receive optimal follow up care.Methods:In 2022, a Stroke Navigator was added to the care team and collaborated with the Stroke Clinic to project volume of clinic slots needed for ischemic and TIA hospital discharges. The Stroke Navigator implemented follow up scheduling with patient/family prior to discharge and emphasized the importance of the 30-day appointment. Pre and postintervention data was then collected and analyzed from Q2 2022 to Q1 2023 regarding timeliness of scheduling, appointment type, and rate of no shows for all ischemic stroke/TIA patients.Results:The pre-intervention scheduling process resulted in an average wait time of 19 days to schedule appointments. Post intervention, no wait time identified as appointments were scheduled prior to discharge. Pre-intervention data on 30-day appointments showed only 23% of patients were scheduled and attended their provider visit, while post-intervention data showed 60% (Table 1). The clinic no show rate went from 19%, down to 10% in the post intervention phase.Conclusion:The Stroke Navigator has made a significant impact on the number of patients with 30-day visits, eliminated the wait time for appointments due to scheduling prior to discharge, and decreased the no show rate for patients at 30 days. Further financial analysis will be critical to validate the impact of a Stroke Navigator, as they are critical to closing the gap in post-acute care.

Circulation, Volume 148, Issue Suppl_1, Page A175-A175, November 6, 2023. Background:Adiponectin (APN) is a cardiovascular-protective adipokine. Our previous research has shown that APN administration reduced cortical neuron apoptosis in mice after resuscitation. Brain microvascular endothelial cell-derived extracellular vesicles (BMEC-sEVs) have neuroprotective properties, and APN regulates BMEC-sEVs’ function to alleviate neuronal apoptosis after resuscitation. However, the specific molecular mechanisms are unclear. MicroRNAs carried by sEVs play essential roles.Hypothesis:APN may alleviate cortical neuron apoptosis by regulating miRNAs carried by BMEC-sEVs.Aims:To investigate if APN attenuates cortical neuron apoptosis in mice after resuscitation by regulating BMEC-sEVs-miRNAs and to elucidate the underlying molecular mechanisms.Methods:BMEC-sEVsAPNwere extracted and identified. BMEC-sEVs were injected into the brain to establish a cardiopulmonary resuscitation mouse model, and cortical neuron apoptosis was assessed. Co-culture experiments were performed between BMEC-sEVs and primary cortical neurons, and apoptosis was evaluated after oxygen-glucose deprivation/reperfusion (OGD/R). Bioinformatics identified miRNAs with pro-apoptotic effects. APN-regulated specific BMEC-sEV miRNAs were screened. Overexpression and inhibition experiments confirmed the neuroprotective effects of the identified miRNA. Target genes were screened, and downstream signaling pathways were explored.Results:APN enhanced the protective effect of BMEC-sEVs against cortical neuron apoptosis. APN preconditioning reduced miR-155-5p and miR-31-5p levels in BMEC-sEVsAPN. MiR-31-5p was highly expressed in primary BMECs and increased after OGD/R. Overexpression of miR-31-5p in cortical neurons aggravated neuronal apoptosis. Inhibition of miR-31-5p reduced apoptotic neurons in Adipoq-/-mice after ROSC. Map3k1 was the most affected target gene of miR-31-5p, and its regulatory role in cortical neuron apoptosis was confirmed.Conclusion:APN alleviates cortical neuron apoptosis after resuscitation by downregulating miR-31-5p expression in BMEC-sEVs; BMEC-sEVsAPNalleviate cortical neuron apoptosis through the miR-31-5p/MAP3K1 signaling pathway.

New England Journal of Medicine, Volume 389, Issue 17, Page 1619-1620, October 2023.

New England Journal of Medicine, Volume 389, Issue 15, Page 1416-1423, October 2023.

A partire dal 27 giugno 2023 è disponibile un aggiornamento dei documenti allegati alla Nota 100 (schede di prescrizione ed elenco dei farmaci)

New England Journal of Medicine, Volume 388, Issue 19, Page 1800-1810, May 2023.

Toccherà alle direzioni sanitarie decidere se estendere l’obbligo anche negli altri reparti e nelle sale d’attesa, mentre medici di famiglia e pediatri decideranno per i loro ambulatori

Objectives
To investigate the prevalence and risk factors of hypothyroidism after universal salt iodisation for 20 years in mainland China.

Design
Nationwide, cross-sectional survey.

Setting and participants
The Thyroid Disorders, Iodine Status and Diabetes epidemiological study included adults from 31 provinces of China. Data included demographic, physical characteristics, urine, serum thyroid-stimulating hormone (TSH), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb) and thyroid ultrasonography. Subclinical hypothyroidism (SCH) was classified into severe SCH (TSH >10 mU/L) and mild SCH (TSH 4.2–9.9 mU/L). A total of 78 470 (38 182 men and 40 288 women) participants were included in the final analysis.

Results
The prevalence of hypothyroidism was 13.95%. The prevalence rates of overt hypothyroidism (OH) and SCH were 1.02% and 13.93%, which mild SCH was significantly higher than severe SCH (12.18% vs 0.75%). Prevalence was higher in women than in men, and this gender difference was noted among all age groups. The prevalence of mild SCH, severe SCH and OH increases by 1.16%, 1.40% and 1.29% for every 10 years older. TPOAb or/and TgAb positive were significantly associated with OH and severe SCH (OR 15.9, p

L’Agenzia Italiana del Farmaco ha aggiornato la Nota 96 (determina AIFA n. 48/2023 pubblicata nella Gazzetta Ufficiale n. 43 del 20 febbraio 2023) sui criteri di appropriatezza prescrittiva della supplementazione con vitamina D e suoi analoghi (colecalciferolo, calcifediolo) per la prevenzione e il trattamento degli stati di carenza nell’adulto