Risultati per: Standard di cura nel diabete 2024

Important revisions include new recommendations for vaccines, cancer screening, and prevention of cardiovascular disease in people with HIV.

Senza DRG, i pazienti non hanno accesso a farmaci e monitoraggio

Senza DRG, i pazienti non hanno accesso a farmaci e monitoraggio

Annals of Internal Medicine, Volume 177, Issue 11, November 2024.

Annals of Internal Medicine, Volume 177, Issue 11, November 2024.

Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.

Each year The ESMO congress offers a thorough educational and scientific platform that facilitates dialogue on translational cancer science, showcased groundbreaking data, and promoted multidisciplinary discussions aimed at enhancing patient care. It provided updates on cancer prevention and screening, highlighted research breakthroughs, analysed clinical perspectives, and deepened understanding of innovative diagnostics and treatments.

Circulation, Volume 150, Issue 21, Page e466-e466, November 19, 2024.

Objective
To assess the effect of goal-directed mobilisation (GDM) on physical functioning in medical inpatients.

Design
Randomised, controlled, single-centre, parallel, superiority trial with a 3-month follow-up and blinded outcome assessment.

Setting
General internal medicine wards of a Swiss tertiary acute hospital, September 2021 to April 2023.

Participants
Adults with expected hospitalisation of ≥5 days, physiotherapy prescription and ability to follow study procedures.

Intervention
GDM during hospitalisation, which includes personal goal setting and a short session of patient education through a physiotherapist (experimental group), versus standard care (control group).

Outcome measures
The primary outcome was the change in physical activity between baseline and day 5 (De Morton Mobility Index (DEMMI)). Secondary outcomes included in-hospital accelerometer-measured mobilisation time; in-hospital falls; delirium; length of stay; change in independence in activities of daily living, concerns of falling and quality of life; falls, readmission and mortality within 3 months.

Results
The study was completed by 123 of 162 (76%) patients enrolled, with the primary outcome collected at day 5 in 126 (78%) participants. DEMMI Score improved by 8.2 (SD 15.1) points in the control group and 9.4 (SD 14.2) in the intervention group, with a mean difference of 0.3 (adjusted for the stratification factors age and initial DEMMI Score, 95% CI –4.1 to 4.8, p=0.88). We did not observe a statistically significant difference in effects of the interventions on any secondary outcome.

Conclusions
The patient’s physical functioning improved during hospitalisation, but the improvement was similar for GDM and standard of care. Improving physical activity during an acute medical hospitalisation remains challenging. Future interventions should target additional barriers that can be implemented without augmenting resources.

Trial registration number
NCT04760392.

Circulation, Ahead of Print. This is the eighth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recent published resuscitation evidence reviewed by the International Liaison Committee on Resuscitation task force science experts. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research.

Circulation, Ahead of Print. Codeveloped by the American Heart Association and the American Red Cross, these guidelines represent the first comprehensive update of first aid treatment recommendations since 2010. Incorporating the results of structured evidence reviews from the International Liaison Committee on Resuscitation, these guidelines cover first aid treatment for critical and common medical, traumatic, environmental, and toxicological conditions. This update emphasizes the continuous evolution of evidence evaluation and the necessity of adapting educational strategies to local needs and diverse community demographics. Existing guidelines remain relevant unless specifically updated in this publication. Key topics that are new, are substantially revised, or have significant new literature include opioid overdose, bleeding control, open chest wounds, spinal motion restriction, hypothermia, frostbite, presyncope, anaphylaxis, snakebite, oxygen administration, and the use of pulse oximetry in first aid, with the inclusion of pediatric-specific guidance as warranted.

I moderni dispositivi permettono di adattare la terapia insulinica alle esigenze individuali di ciascun paziente, migliorando l’efficacia del trattamento

A 5 anni dall’arrivo in Italia trattati oltre 1.400 pazienti

New England Journal of Medicine, Volume 391, Issue 19, Page 1838-1846, November 14, 2024.

Circulation, Ahead of Print. Drowning is the third leading cause of death from unintentional injury worldwide, accounting for 7% of all injury-related deaths. The World Health Organization estimates that there are ≈236 000 deaths due to drowning worldwide each year. Significant efforts have focused on creating systems to prevent drowning, but an average of 4000 fatal and 8000 nonfatal drownings still occur annually in the United States—likely an underestimate. Drowning generally progresses from initial respiratory arrest due to submersion-related hypoxia to cardiac arrest; thus, it can be challenging to distinguish respiratory arrest from cardiac arrest because pulses are difficult to accurately palpate within the recommended 10-second window. Therefore, resuscitation from cardiac arrest attributable to this specific circumstance must focus on restoring breathing as much as it does circulation. Resuscitation from drowning may begin with in-water rescue breathing when safely provided by rescuers trained in the technique and should continue with chest compressions, in keeping with basic life support guidelines, once the drowned individual and the rescuer are in a safe environment (eg, dry land, a boat). This focused update incorporates systematic reviews from 2021 to 2023 performed by the International Liaison Committee on Resuscitation related to the resuscitation of drowning. These clinical guidelines are the product of a committee of experts representing the American Heart Association and the American Academy of Pediatrics. The writing group reviewed the recent International Liaison Committee on Resuscitation systematic reviews, including updated literature searches, prior guidelines related to resuscitation from cardiac arrest following drowning, and other drowning-related publications from the American Heart Association and American Academy of Pediatrics. The writing group used these reviews to update its recommendations aimed at resuscitation of cardiac arrest following drowning in adults and children.

Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.