Risultati per: Quotidianosanita.it

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Volume 392, Issue 21, Page 2151-2158, June 5, 2025.

Annals of Internal Medicine, Ahead of Print.

Bleeding after cardiac surgery with cardiopulmonary bypass is associated with adverse clinical outcomes and increased resource utilization. Broadly speaking, this bleeding can be due to inadequate surgical hemostasis or microvascular bleeding caused by bypass-induced platelet dysfunction and/or depletion of coagulation factors. The most common method of restoring coagulation factors in this setting is through the transfusion of thawed frozen plasma, which occurs in approximately 25% of cardiac surgeries. Plasma is generally regarded as a safe treatment, with very low rates of transfusion-related acute lung injury (

Objectives
To explore the reporting barriers and related factors of medication errors among nurses in hospitals in China and provide a reference for safe medication management in hospitals.

Design
Cross-sectional, online survey.

Setting
Responses were collected online from September 2022 to November 2022 across a specific tertiary hospital in Chengdu, China.

Participants
Clinical registered nurse.

Primary outcome measure
Measure the Barriers to Medication Administration Error (MAE) Reporting Questionnaire, Face-Saving Scale, the Index of Hierarchy of Authority and the Working Environment Questionnaire. Independent sample t-test, correlation analysis and multiple linear regression analysis were performed to identify factors associated with the barriers to MAE reporting.

Results
432 (97.30%) nurses responded. Nurses’ standardised scores of barriers to MAE reporting were 3.01 (SD=1.01); the fear dimension items have the highest standardised score of 3.42 (SD=1.11). Working environment is negatively correlated with barriers to MAE reporting (r=–0.201, p

Stroke, Volume 56, Issue 5, Page 1351-1364, May 1, 2025.

New England Journal of Medicine, Ahead of Print.

Acute pancreatitis (AP) in children presents unique challenges distinct from adult manifestations, requiring specialized diagnostic and therapeutic approaches. Compared to adults, pediatric AP has lower mortality rates but still carries significant morbidity and potential long-term complications. This review examines current evidence on pediatric AP, highlighting recent advances in diagnosis, risk stratification, and management strategies. Current diagnostic approaches utilize serum lipase and amylase testing, along with various imaging modalities that have different diagnostic values.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Volume 178, Issue 4, Page 596-597, April 2025.

Ductal carcinoma in situ (DCIS) is considered a nonobligate precursor of invasive breast cancer. Surgery is thought to reduce this risk, as evidenced by studies demonstrating cause-specific survival of 97% to 98% after treatment with mastectomy or lumpectomy with or without radiotherapy. Invasive cancer is found at surgical excision in 26% of all women diagnosed with DCIS by core biopsy and in 20% of those with low- to intermediate-grade DCIS or lesions of 2 cm or smaller on mammography. Despite the apparent success of surgery, significant concerns about overtreatment of DCIS have been raised. The substantial increase in the detection of DCIS between 1992 and 2011 that coincided with the widespread adoption of screening mammography did not result in parallel reductions in invasive cancer detection or breast cancer mortality, suggesting that a proportion of the DCIS being identified would have never progressed to invasive cancer. The very high cause-specific survival after surgery and the limited knowledge of the evolution of untreated DCIS raises the possibility that similar excellent outcomes might be obtained with a less aggressive approach such as active monitoring, with surgery reserved for patients showing evidence of progression to invasive cancer; however, the safety of this approach is uncertain. Ideally, a subset of DCIS patients at low risk of progression to invasive cancer could be identified by molecular profiling, but at present, this goal remains aspirational.

Objectives
Transient loss of consciousness (TLOC) is one of the most common neurological complaints in the Emergency Department (ED), but little is known about the patient perspective. We aimed to explore patient perceptions of diagnostic assessment for TLOC.

Setting
ED, Acute Medical Unit and Syncope and Neurology clinics in a single tertiary teaching hospital in the north of England.

Participants
20 adult patients (60% female, age range 17–90 years) attending or referred with a first presentation of TLOC.

Primary and secondary outcome measures
Exploratory thematic analysis of semistructured qualitative interviews.

Results
We identified three themes within the data: satisfaction with care, unanswered questions and being left in limbo/no man’s land. Participants explored these themes through four topics: communication; the role of investigations; the role of authority and the social context of care.

Conclusions
Communication (including differential diagnosis, significance of investigations and further assessments, and interim safety advice) is emphasised in supporting ongoing self-management, even before a definitive diagnosis is made.

Introduction
Benzodiazepine receptor agonists (BZRA) deprescribing interventions are needed to tackle high BZRA use in the older population. This study aims to assess the feasibility of the D-PRESCRIBE intervention, adapted from Canada to the Belgian community setting. This pharmacist-led intervention comprises a patient educational brochure and a pharmacist-to-prescriber communication tool.

Methods and analysis
We will conduct a feasibility study of a cluster randomised controlled trial involving 8–10 community pharmacies (clusters) and aiming to recruit 56–80 patients (≥65 years). Intervention pharmacies will deliver the adapted D-PRESCRIBE intervention and control pharmacies, usual care. Patients will be blinded to group allocation. Quantitative data will be collected at baseline, 3 months and 6 months through patients’ and pharmacists’ questionnaires, aiming: (1) to test the feasibility of the intervention, (2) to test the feasibility of the study design needed for its evaluation and (3) to perform an exploratory cost-effectiveness analysis. Hence, data about implementation outcomes, mechanisms of impact (ie, mechanisms through which the intervention is supposed to be effective) and contextual factors will be gathered. Patient-centred outcomes will also be collected as they would be in a full cost-effectiveness trial. The feasibility of the study design will be assessed through participation rate, completeness of the data and a satisfaction survey, sent to participants after the 6-month data collection. Data will be analysed using descriptive statistics. To gain a deeper understanding of pharmacists and patients’ experience with the intervention, interviews will be conducted after the 6-month data collection and the Theoretical Domains Framework will be used as a deductive framework for analysis.

Ethics and dissemination
This study was approved by the Ethics Committee of CHU UCL Namur (NUB: B0392023000036). Participants will receive a summary of the results. Results will also be disseminated through the organisation of a local symposium and a peer-reviewed publication.

Trial registration number
NCT05929417.