Risultati per: Trattamento delle infezioni alle vie urinarie con pidotimod: tre case report

Objectives
To delineate the clinical characteristics and investigate the determinants that may affect the prognosis of surgical patients with abdominal sepsis.

Design
A case-control study was nested in a cohort of surgical patients with abdominal sepsis between 2008 and 2022. We extracted patient’ medical records to execute descriptive statistical analyses. Multiple logistic regression models and subgroup analysis were employed to elucidate the risk factors of in-hospital mortality.

Setting
Two tertiary hospitals in China.

Participants
476 surgical patients diagnosed with abdominal sepsis between 2008 and 2022 were analysed.

Interventions
None.

Outcome measures
Descriptive statistics were used to examine pertinent patient information, including demographic details, laboratory findings, surgical interventions and anaesthetic records. Multivariate logistic regression was used to identify independent risk factors for in-hospital mortality. Subgroup analyses were conducted to explore the impact of specific clinical characteristics on outcomes.

Results
476 patients diagnosed with abdominal sepsis were analysed, exhibiting an in-hospital mortality rate of 7.56%. Advanced age (OR 6.77, 95% CI 2.46 to 18.66, p

New England Journal of Medicine, Volume 392, Issue 16, Page 1637-1645, April 24, 2025.

This Viewpoint discusses discordance between patient report and objectively measured walking impairment in people with peripheral artery disease without critical leg ischemia and how this discordance affects clinical care and scientific investigation.

Objectives
The study aimed to identify the predictive factors associated with virological failure among adult patients living with HIV on first-line highly active antiretroviral therapy (HAART) in selected hospitals in Southeast Oromia, Ethiopia.

Design
A facility-based unmatched case–control study was conducted.

Setting
The study was conducted in three selected hospitals in Southeast Oromia, Ethiopia.

Participants
The study included a final sample size of 282 participants, comprising 94 cases and 188 controls. A simple random sampling technique was employed to select participants.

Main outcomes measurement
The main outcome of this study was virological failure among adult patients living with HIV on first-line HAART. Virological failure was defined as a binary outcome: a case indicated the presence of failure, defined as adults aged≥15 years with a viral load (VL) >1000 copies/mm3 in two consecutive measurements taken 3 months apart, following enhanced adherence counselling (EAC) after 6 months of treatment. A control indicated the absence of failure, defined as patients aged≥15 years with a VL

New England Journal of Medicine, Volume 392, Issue 15, Page 1532-1543, April 17, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1428-1437, April 10, 2025.

Objectives
Ineffective erythropoiesis, although at a mild degree, could make individuals with beta thalassaemia trait (BTT) vulnerable to folate deficiency. This could be more pronounced in communities where dietary intake of folate is substantially lower. We aimed to assess serum folate levels and dietary folate consumption in individuals with BTT and compare them with healthy matched controls.

Design
A case–control study.

Setting
This study was conducted between June 2021 and June 2022 at a regional thalassaemia centre in Sri Lanka.

Participants
The study includes 100 sets of samples, including a BTT and an age-matched, sex-matched and body mass index-matched healthy individual from the same household in each set, aged between 6 and 25 years.

Primary and secondary outcome measures
The primary outcomes were serum folate levels and the daily dietary intake of folate in BTTs and controls. Serum folate levels were determined using a fully automated Cobas immunoassay analyser. The dietary folate intake was determined by recording 24-hour dietary recall recorded over 3 consecutive days, with the average intake calculated.

Results
The results suggested that 34% of cases and 24% of controls had serum folate deficiency (

Objective
The aim of this study was to investigate the incidence, risk factors and airway management of postoperative haematoma following anterior cervical spine surgery (ACSS).

Design
A retrospective nested case-control study.

Setting
A tertiary hospital in China.

Participants
A total of 13 523 patients within a single-centre longitudinal ACSS cohort were identified from March 2013 to February 2022. Patients with postoperative haematoma after ACSS were enrolled as the haematoma group, and others in the cohort without haematoma were randomly selected as the non-haematoma group by individually matching with the same operator, same gender, same surgery year and similar age (±5 years) at a ratio of 4:1. Subsequently, patients with haematoma were included in a subgroup for analysis.

Primary outcome measures
Postoperative haematoma and difficult intubation prior to haematoma evacuation.

Results
The incidence of postoperative haematoma out of all ACSS was 0.4% (55/13 523). A total of 275 patients were enrolled in the study, including 55 patients in the haematoma group and 220 patients in the non-haematoma group. Anterior cervical corpectomy and fusion (ACCF) (OR 2.459; 95% CI 1.302 to 4.642; p =0.006) and the maximum mean arterial pressure (MAP) during recovery (OR 1.030; 95% CI 1.003 to 1.058; p =0.028) were identified as independent risk factors for haematoma. In the subgroup analysis, 29% of patients with haematoma experienced difficult intubation, and retropharyngeal haematoma (OR 10.435; 95% CI 1.249 to 87.144; p =0.030) was identified as an independent risk factor for difficult intubation. Patients with haematoma had longer hospitalisation duration (p

Circulation, Volume 151, Issue 14, Page e918-e918, April 8, 2025.

Introduction
Domestic violence is a key risk factor for suicidal behaviour. While there is some evidence on the association between suicide and victimisation, there is a notable paucity of evidence pertaining to the perpetration of domestic violence and its association with suicidal behaviour. The aim of this study is to investigate the association between domestic violence (victimisation and perpetration) and self-poisoning in Sri Lanka.

Methods and analysis
This is a hospital-based case-control study. Cases (n=260) will be individuals admitted to the toxicology ward of the Teaching Hospital Peradeniya, Sri Lanka, for medical management of self-poisoning. We will recruit controls (n=520) from other patients with unrelated conditions or accompanying visitors presenting to the outpatient department of Teaching Hospital Peradeniya. We will use unconditional logistic regression models to investigate the association between domestic violence and self-poisoning.

Ethics and dissemination
We obtained ethics approval from the Ethical Review Committee of the Faculty of Medicine, University of Peradeniya, Sri Lanka. The research assistants will be trained in administering the questionnaire and ensuring participant safety. Results will be disseminated in peer-reviewed articles, local media and at national and international conferences.

Circulation, Ahead of Print. BACKGROUND:Real-world low-risk transcatheter aortic valve replacement (TAVR) outcomes in the United States have not been assessed comprehensively versus pivotal trials, which is a key component of measuring the quality of clinical technology adoption.METHODS:We identified heart team–designated low-risk patients undergoing TAVR for trileaflet severe, symptomatic aortic stenosis in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Registry, as well as a subset of patients who met low-risk trial inclusion and exclusion criteria, from January 2020 to March 2024. Outcomes (mortality, stroke, new pacemaker, and “alive and well,” defined as alive at 1 year with Kansas City Cardiomyopathy Questionnaire score ≥60 and ≤10-point decrease from baseline) at 30 days and 1 year were assessed. Multivariable models were developed to assess predictors of death within 1 year after TAVR.RESULTS:Among 383 030 patients who underwent TAVR during the study period, 108 407 (28%) were designated low risk by the heart team, and 68 194 (18%) met other study inclusion and exclusion criteria. Of these, 62% (n=42 093) would have been eligible for the low-risk trials. In the overall heart team–designated low-risk population, 30-day outcomes included 0.8% mortality, 1.5% stroke, and 8.4% new permanent pacemaker requirement; 1-year outcomes included 4.6% mortality, 2.6% stroke, and 90% alive and well. In the trial-eligible population, 0.6% mortality, 1.4% stroke, and 8.0% new permanent pacemaker requirement had occurred by 30 days; values at 1 year included 3.1% mortality, 2.4% stroke, and 92% alive and well. Notable multivariable predictors of 1-year mortality were atrial fibrillation, nontransfemoral access, and lower baseline Kansas City Cardiomyopathy Questionnaire score.CONCLUSIONS:One-year outcomes among real-world trial-eligible patients are excellent, but adverse events are higher compared with published clinical trial data, likely because of greater comorbidity burden and lower baseline Kansas City Cardiomyopathy Questionnaire score. These data can help inform expected outcomes and health status after low-risk TAVR.

This Viewpoint discusses the concept of skin failure, the breakdown of skin in aging and critically ill patients; how it differs from pressure injury; and future areas of research regarding the process.

This Viewpoint discusses the medical, ethical and legal conflicts clinicians face with the mandate to equally protect the health of the pregnant person and the fetus.

Circulation, Volume 151, Issue 13, Page e865-e865, April 1, 2025.