Minerva medica
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Asthma is a serious global health problem affecting all age groups, with global prevalence. Although controller medications are usually highly effective asthma treatments, patient adherence remains poor, and under-use is associated with greater health resource use, morbidity, and mortality. ⋯ The results suggested that inhaler reminders may represent an effective strategy for improving adherence in primary care compared with a behavioral intervention or usual care, although this may not be reflected in differences in levels of asthma control. Studies in larger population are needed in order to test the efficacy of available technology on asthma outcomes in all age stages.
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Asthma is the most common respiratory disorder complicating pregnancy, and is associated with a range of adverse maternal and perinatal outcomes. There is strong evidence however, that the adequate control of asthma can improve health outcomes for mothers and their babies. Despite known risks of poorly controlled asthma during pregnancy, a large proportion of women have sub- optimal asthma control, due to concerns surrounding risks of pharmacological agents, and uncertainties regarding the effectiveness and safety of different management strategies. ⋯ These results are consistent with asthma management guidelines and provide scientific evidence to help physicians and mothers make evidence-based treatment decisions during pregnancy, particularly when a step up to higher doses of ICS or addition of a LABA is required. These reassuring results should encourage women to continue their asthma medications when required to control their asthma during pregnancy and increase the likelihood of healthy pregnancies and newborns. This commentary focuses on some critical issues of this recent work and to the need of future study to evaluate the safety during pregnancy of novel molecules recently introduced for asthma treatment.
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Recent studies have reported that the lncRNA-LET was down-regulated in several cancers.The current meta-analysis aims to determine whether lncRNA-LET can be used as a potential biomarker for metastasis and prognosis. ⋯ LncRNA-LETmay serve as a common molecular marker for metastasis and prognosis in human cancers.
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Meta Analysis
The clinical risk factors associated with postoperative bile leakage after hepatectomy: a meta-analysis.
The occurrence of bile leakage (BL) is one of the major contributors to the morbidity after hepatectomy. However, the clinical risk factors associated with postoperative BL remains controversial. This study aims to further assess the risk factors for BL. ⋯ Our meta-analysis reveals that previous liver or biliary surgery, anatomic resection, major hepatectomy, right anterior sectionectomy, left trisectionectomy, central bisectionectomy, blood transfusion, operative time, bile duct reconstruction, resection of segments 1, 2 and 5 involved had significant positive correlation with increased risk of BL, on the contrary, hepatic fibrosis/cirrhosis, left lateral sectionectomy had the opposite effect.
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Multicenter Study
Activity-based costing analysis of the analgesic treatments used in postoperative pain management in Italy.
The aim of this analysis is to evaluate the costs of 72-hour postoperative pain treatment in patients undergoing major abdominal, orthopedic and thoracic procedures in nine different Italian hospitals, defined as the cumulative cost of drugs, consumable materials and time required for anesthesiologists, surgeons and nurses to administer each analgesic technique. ⋯ The analysis successfully collected information about costs of 72-hour postoperative pain treatment in patients undergoing major abdominal, orthopedic and thoracic procedures in all the nine different Italian hospitals. The interview showed high heterogeneity in the treatment of moderate to severe pain after major abdominal, orthopedic and thoracic surgeries among responding anesthesiologists, with 15 different analgesic modalities reported. The majority of the analgesic techniques considered in the analysis is not recommended by any guideline and their application in real life can be one of the reasons for the high incidence of uncontrolled pain, which is still reported in the postoperative period. Health care costs have become more and more important, although the choice of the best analgesic treatment should be a compromise between efficacy and economic considerations.