1,721,050 research outputs found
Synovial fluid and serum concentretions of inflammatory markers in rheumatoid arthritis, psoriatic arthritis and osteoarthritis: a systematic review
No full textBackground: The aim of this review is to investigate systematically the presence of the most extensively studied synovial fluid (SF) and/or serum markers in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and osteoarthritis (OA), and their associations and correlations with laboratory and clinical data, with a view to providing insights for future research. Objective: Papers were selected using the PRISMA flow-chart. Search of the electronic databases according to the above criteria found a total of 55 papers. Examination led to the exclusion of 39 papers. Finally, 16 studies met the inclusion criteria and are reviewed. As regards to interleukins we found: higher TNF-α levels in patients with early RA and PsA than in those with osteoarthritis (p<0.05); higher IL-6 levels in patients with inflammatory arthritis (RA and PsA) than in those with OA (p=0.032) and higher IL-17 levels in SF from PsA patients than RA patients (p=0.04) and a sig- nificant difference in serum levels between PsA patients and healthy controls (p=0.013) and higher IL-22 SF levels in PsA than OA patients (p<0.001) and in RA compared with OA patients (p<0.01). As regards chemokine, CCL-22 was higher in SF from RA and PsA patients than in OA patients (p<0.01). Method: Considering the sample size of the studies reviewed here, their findings need confirmation in larger samples, while the potential prognostic value of SF and/or serum biomarkers requires prospective investigation. Conclusion: The limitations of the biological SF assays and the problems encountered in the attempted use of cytokine assays for diagnostic purposes must be addressed
HPV-vaccination and cancer cervical screening in 53 WHO European Countries: An update on prevention programs according to income level
Full text linkHuman papillomavirus (HPV) is the most common sexually transmitted disease in the world. The aim of our study is to describe the differences in HPV-vaccination coverage and screening programs in WHO European Countries notably according to income levels. Multiple correspondence analysis was applied to examine the association among the following variables: Gross National Income (GNI) levels (Lower-Middle Income, LMI; Upper-Middle Income, UMI; and High Income, HI); type of CC screening program (coverage; opportunistic/organized); vaccination payment policies (free or partial or total charge); mortality rates/100 000 (≤3; >3-6; >6-9; >9); incidence rates/100 000 (≤7; >7-15; >15-21; >21). Data HPV-vaccination start (years) (2006-2008; 2009-2011; 2012-2014; >2014; no program); coverage HPV-vaccination percentage (≤25; 26-50; 51-75; >75); data screening start (years) (<1960; 1960-1980; 1981-2000; >2000); primary screening test (HPV, cytology), and screening coverage percentage (≤25; >25-50; >50-75; >75). A high income is associated with: start of screening before 1960, medium-high screening coverage, organized screening, start of vaccination in the periods 2009-2011 and 2012-2014 and high immunization coverage. On the other hand, lower-middle income is associated with: late start of vaccination and screening programs with cytology as primary test, high mortality and incidence rates and lower-medium vaccination coverage. Our results show a useful scenario for crucial support to public health decision-makers. Public health authorities should monitor the HPV-vaccinated population in order to determine more precisely the effects on short- and long-term incidence and mortality rates. In fact, the greater the vaccination coverage, the greater will be the efficacy of the program for the prevention of CC and other HPV-related diseases
Overview of meta-analyses: The impact of dietary lifestyle on stroke risk
Full text linkA stroke is one of the most prevalent cardiovascular diseases worldwide, both in high-income countries and in medium and low-medium income countries. The World Health Organization's (WHO) report on non-communicable diseases (NCDs) indicates that the highest behavioral risk in NCDs is attributable to incorrect nutrition. The objective of our work is to present an overview of meta-analyses that have investigated the impact of different foods and/or drinks in relationship with the risk of stroke events (ischemic/hemorrhagic). The papers to be included in the overview were found in MEDLINE, EMBASE, Scopus, Clinicaltrials.gov, Web of Science, and Cochrane Library and were selected according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow chart. Quality assessment were made according to the AMSTAR 2 scale. This overview shows that all primary studies came from countries with high income levels. This evidence shows that many countries are not represented. Therefore, different lifestyles, ethnic groups, potentially harmful or virtuous eating habits are not reported. It is important to underline how the choose of foods may help reduce the risk of cardiovascular diseases and stroke in particular
Abdominal Aortic Screening Is a Priority for Health in Smoker Males: A Study on Central Italian Population
Full text linkAbdominal aortic aneurysm (AAA) is a major public health problem. In the last decade, in some European countries, abdominal aortic screening (AAS) is emerging as a potential prevention for the rupture of AAA. The goals of our study were to estimate AAA prevalence and risk factors in males and females in a central Italian population, also defining the cost-effectiveness of AAS programs. A pilot study screening was conducted between 1 January 2015 and 31 December 2019 in the municipality of Teramo (Abruzzo Region, Italy) in a group of men and women, ranging from the age of 65 to 79, who were not previously operated on for AAA. The ultrasound was performed by means of Acuson sequoia 512 Simens with a Convex probe. The anterior posterior of the infra-renal aorta was evaluated. The odds ratio values (ORs) were used to evaluate the risk of AAA, and the following determinants were taken into consideration: gender, smoke use, hypertension, and ischemic heart disease. We also estimated the direct costs coming from aneurysmectomy (surgical repair or endovascular aneurysms repair—EVAR). A total of 62 AAA (2.7%, mean age 73.8 ± 4.0) were diagnosed, of which 57 were in men (3.7%, mean age 73.6 ± 4.0) and 5 were in women (0.7%, mean age 74.3 ± 4.1). Male gender and smoke use are more important risk factors for AAA ≥ 3 cm, respectively: OR = 5.94 (2.37–14.99, p < 0.001) and OR = 5.21 (2.63–10.30, p < 0.000). A significant increase in OR was noted for AAA ≥ 3 cm and cardiac arrhythmia and ischemic heart disease, respectively: OR = 2.81 (1.53–5.15, p < 0.000) and OR = 2.76 (1.40–5.43, p = 0.006). Regarding the cost analysis, it appears that screening has contributed to the reduction in costs related to urgency. In fact, the synthetic indicator given by the ratio between the DRGs (disease related group) relating to the emergency and those of the elective activity went from 1.69 in the year prior to the activation of the screening to a median of 0.39 for the five-year period of activation of the screening. It is important to underline that the results of our work confirm that the screening activated in our territory has led to a reduction in the expenditure for AAA emergency interventions, having increased the planned interventions. This must be a warning for local stakeholders, especially in the post-pandemic period, in order to strengthen prevention
Regional variability in the epidemiology of childhood diabetes in Italy
No full textThe incidence rates of IDDM in Italy show remarkable variability. Sardinia, a region with the second highest incidence rate in the world, co-exists with other regions with lower rates. We review and compare epidemiologic data on the incidence of childhood-onset IDDM in Italy. papers published from 1980 to 1996 reporting incidence data in Italian areas were found by search of Medline and non-indexed Italian journals. The incidence data found cover only 57% of the Italian population. The analysis of our results shows how difficult it is to make a careful study of epidemiology of IDDM in Italy. The RIDI (the Registry for Insulin-dependent Diabetes mellitus in Italy) project started in 1996 according to international guidelines. The aims is to coordinate local IDDM registries, to promote the start of new registries in uncovered areas, and to standardize registration and data collection
The Effects of the Ukrainian Conflict on Oncological Care: The Latest State of the Art
No full textBackground: The COVID-19 pandemic has dramatically affected all aspects of the patient’s
pathway to cancer diagnosis and subsequent treatment. Our main objective was to evaluate the status
of cancer trials in Ukraine as of September 2022. Methods: Initially, we examined with a narrative
review the state of breast, colorectal, and cervical cancer population-based screening. Subsequently,
we assessed each trial status for the years 2021 and 2022. Results: Estimates of participation in breast
and cervical cancer screening are different from region to region. Moreover, regarding cervical cancer
screening, extremely different participation estimates were reported: 73% in 2003 vs. <10% 2020.
Our data show that from 2014 to 2020, despite the pandemic, cancer trials in Ukraine significantly
increased from 27 to 44. In 2021 no trials were completed; in fact, we observed that out of 41 trials,
8 were active not recruiting, 33 were recruiting, and 0 were completed or terminated. In 2022 in
Ukraine, for oncological pathologies, only 3 trials were registered, while in 2021, 41 trials were
registered. The suspension of trials regarded above all concern hematological tissue (66.7%) and the
genitourinary tract (60%). Conclusions: Our work has highlighted how the areas most affected by the
conflict present criticalities in oncological care
The impact of human milk on necrotizing enterocolitis: A systematic review and meta-analysis
Full text linkBackground. Premature infants receiving breastfeed have a lower incidence of NEC than those fed preterm formula. This study aimed: (1) to update a systematic review and meta-analyses to evaluate the relationship between feeding and necrotizing enterocolitis (NEC) in low weight premature infants; (2) to conduct meta-regression analyses by subgroups; (3) to describe geographical distribution of milk banks in the world. Methods. Papers included in the meta-analysis were updated as of June 2019. Relative risks were used as a measure of effect size. Random effect models were used to account for different sources of variation among studies. For milk banks, the data reviewed by the literature were integrated with the information collected from countries’ institutional sites and milk bank networks. Results. Thirty-two papers were included in meta-analysis: six randomized controlled trials (RCTs) and 26 observational studies (OS). The census has found 572 milk banks around in the world. Brazil has the most active milk banks. RCTs meta-analysis indicates a risk reduction of NEC using human milk respect to formula: Relative risk (RR) = 0.62 (0.42–0.93). Seven OS compared quantities lower than human milk or higher than the 50th quantile showing a risk reduction of NEC:RR = 0.51 (0.31–0.85); 3 OS that evaluated human milk versus mixed feeding showing that human milk has a protective role on the development of NEC:RR = 0.74 (0.63–0.91). Results of subgroups analysis show that the risk reduction is statistically significant only for studies in which premature infants are given both their own and donated breastmilk. Conclusions. The possibility of preserving human milk and promoting donations guarantees an improvement in the health of newborns
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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