Un declino demografico iniziato nel 2015, continuo, ininterrotto, come non accadeva da 90 anni. Oggi sappiamo che assistiamo a domicilio meno di 3 anziani su 100. Tutti gli altri? Intasano i pronto soccorso, nella migliore delle ipotesi, oppure a casa, soccorsi dalle cure ‘fai da te’ di familiari e badanti, il più delle volte in nero, quando non abbandonati perché non hanno le risorse per farsi assistere. Alzate lo sguardo dalla gabbia del “contratto di governo” e abbassatelo sull’Italia vera.
Archivi categoria: farmacoeconomia
Si è svolta ieri in AIFA la presentazione del Rapporto Nazionale 2018 “L’Uso dei Farmaci in Italia”: sono intervenuti Luca Li Bassi, Francesco Trotta, Silvio Garattini, Armando Bartolazzi.
Association of Acute Increases in Plasma Creatinine after Renin-Angiotensin Blockade with Subsequent Outcomes | American Society of Nephrology
Background and objectives Data from observational and interventional studies provide discordant results regarding the relationship between creatinine increase after renin-angiotensin system inhibition (RASi) and adverse outcomes. We compared health outcomes among patients with different categories of increase in creatinine upon initiation of RASi in a large population-based cohort. Design, setting, participants, & measurements We performed a retrospective analysis of the Stockholm CREAtinine Measurements database, which contains complete information on diagnoses, medication dispensation claims, and laboratory test results for all Stockholm citizens accessing health care. Included were 31,951 adults initiating RASi during 2007–2011 with available pre- and postinitiation creatinine monitoring. Multivariable Cox regression was used to compare mortality, cardiovascular and ESKD events among individuals with different ranges of creatinine increases within 2 months after starting treatment. Results In a median follow-up of 3.5 years, acute increases in creatinine were associated with mortality (3202 events) in a graded manner: compared with creatinine increases <10%, a 10%–19% increase
The Use of Erythropoiesis-Stimulating Agents in Patients With CKD and Cancer: A Clinical Approach – American Journal of Kidney Diseases
Erythropoiesis-stimulating agents (ESAs) have been used to manage anemia in chronic kidney disease (CKD) to reduce transfusion requirements and anemia symptoms. Lack of objective benefit of normalizing hemoglobin (Hb) levels and increased evidence of ESA-induced complications in persons with anemia has resulted in clinicians generally attempting to maintain Hb levels in the 10- to 11-g/dL range. In 2000, concerns in patients with cancer arose attributable to associations of ESA use with increased mortality, thrombotic complications, and cerebrovascular accidents led to a change in US Food and Drug Administration oncology guidelines regarding limitation of ESA use for chemotherapy-induced anemia.