Search Results for: AGA: linee guida sulla de-prescrizione degli inibitori della pompa protonica
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Su1035 COMPLIANCE WITH THE AGA QUALITY MEASURE FOR HELICOBACTER PYLORI TESTING IN INDIVIDUALS WITH GASTRIC INTESTINAL METAPLASIA: A SECOND LOOK
Su2039 A CENTRALIZED INTERPRETATION OF DE-IDENTIFIED PEDIATRIC HIGH-RESOLUTION MANOMETRY STUDIES FROM A MULTICENTER COHORT: CHICAGO CLASSIFICATION V4.0 PROTOCOL IS OFTEN NOT FOLLOWED, BUT DIAGNOSIS CHANGES ARE MOSTLY NON-ACTIONABLE
Mo1058 SMALL EDUCATIONAL GRANTS HAVE AN OUTSIZED IMPACT FOR AGA MEMBERS
382 AMONG PATIENTS WITH IBD USE OF STATINS IS ASSOCIATED WITH LOWER RISK OF DEVELOPING DE NOVO PRIMARY SCLEROSING CHOLANGITIS
Mo1318 THE MUCOSAL PROTECTIVE AGENT POLIPROTECT IS AN EFFECTIVE TREATMENT TO MANAGE PPI DE-PRESCRIBING. IN NON-EROSIVE HEARTBURN AND EPIGASTRIC PAIN SYNDROME PATIENTS. RCT POST HOC ANALYSIS DATA
Tu1623 THE DEVELOPMENT OF DE-NOVO MALIGNANCY IN HCV-INFECTED ALLOGRAFTS AFTER LIVER TRANSPLANTATION IN DIRECT-ACTING ANTIVIRAL ERA
Sa1659 DE NOVO HEPATOCELLULAR CARCINOMA (HCC) IN NON-CIRRHOTIC CHRONIC VIRAL HEPATITIS C (HCV) PATIENTS: A CASE SERIES
Diagnosi e trattamento della vescica iperattiva idiopatica: linea guida
Lo scopo di questa linea guida pubblicata dall’American Urological Association […]
Assistenza di sopravvivenza per persone affette da cancro avanzato o metastatico: linea guida
Le persone con cancro avanzato o metastatico e i loro […]
Perdita dell’udito legata all’età: linea guida
La perdita dell’udito legata all’età (ARHL) è una condizione diffusa […]
Novel point-of-care cytokine biomarker lateral flow test for the screening for sexually transmitted infections and bacterial vaginosis: study protocol of a multicentre multidisciplinary prospective observational clinical study to evaluate the performance and feasibility of the Genital InFlammation Test (GIFT)
Introduction
A prototype lateral flow device detecting cytokine biomarkers interleukin (IL)-1α and IL-1β has been developed as a point-of-care test—called the Genital InFlammation Test (GIFT)—for detecting genital inflammation associated with sexually transmitted infections (STIs) and/or bacterial vaginosis (BV) in women. In this paper, we describe the rationale and design for studies that will be conducted in South Africa, Zimbabwe and Madagascar to evaluate the performance of GIFT and how it could be integrated into routine care.
Methods and analysis
We will conduct a prospective, multidisciplinary, multicentre, cross-sectional and observational clinical study comprising two distinct components: a biomedical (‘diagnostic study’) and a qualitative, modelling and economic (‘an integration into care study’) part. The diagnostic study aims to evaluate GIFT’s performance in identifying asymptomatic women with discharge-causing STIs (Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Mycoplasma genitalium (MG)) and BV. Study participants will be recruited from women attending research sites and family planning services. Several vaginal swabs will be collected for the evaluation of cytokine concentrations (ELISA), STIs (nucleic acid amplification tests), BV (Nugent score) and vaginal microbiome characteristics (16S rRNA gene sequencing). The first collected vaginal swab will be used for the GIFT assay which will be performed in parallel by a healthcare worker in the clinic near the participant, and by a technician in the laboratory. The integration into care study aims to explore how GIFT could be integrated into routine care. Four activities will be conducted: user experiences and/or perceptions of the GIFT device involving qualitative focus group discussions and in-depth interviews with key stakeholders; discrete choice experiments; development of a decision tree classification algorithm; and economic evaluation of defined management algorithms.
Ethics and dissemination
Findings will be reported to participants, collaborators and local government for the three sites, presented at national and international conferences, and disseminated in peer-reviewed publications.
The protocol and all study documents such as informed consent forms were reviewed and approved by the University of Cape Town Human Research Ethics Committee (HREC reference 366/2022), Medical Research Council of Zimbabwe (MRCZ/A/2966), Comité d’Ethique pour la Recherche Biomédicale de Madagascar (N° 143 MNSAP/SG/AMM/CERBM) and the London School of Hygiene and Tropical Medicine ethics committee (LSHTM reference 28046).
Before the start, this study was submitted to the Clinicaltrials.gov public registry (NCT05723484).
Trial registration number
NCT05723484.
The SOUND Randomized Clinical Trial Results
To the Editor Gentilini and colleagues should be congratulated for successfully completing the SOUND trial and providing randomized clinical trial evidence for de-escalation of axillary staging in T1N0 (by ultrasonography) invasive breast cancer. De-escalation of treatments in invasive breast cancer is actively considered. However, overtreatment in ductal carcinoma in situ (DCIS) is quite common, for example, upfront sentinel lymph node biopsy (SLNB) in wide local excision when a delayed SLNB is feasible. The current guidelines primarily recommend upfront SLNB in patients with DCIS undergoing mastectomy. Even in those with DCIS undergoing mastectomy, the upgrade to invasive breast cancer is often to microinvasion or T1 stage. This subset of patients will then be potentially eligible for the SOUND trial and could avoid SLNB altogether.
The SOUND Randomized Clinical Trial Results
To the Editor We read with great interest the article by Gentilini and colleagues. The de-escalation of axillary management has evolved from axillary clearance to sentinel lymph node biopsy (SLNB) and further to omission of axillary management even in the presence of 1 to 2 positive sentinel lymph nodes in patients with early breast cancer who undergo breast conservation therapy, which has in turn led to questioning of the role of SLNB in this subset of patients and the concept of noninvasive sonological staging of the axilla. We present a few comments to be considered with regard to the same.
Charting the Path to Systemic Therapy De-escalation
This Viewpoint discusses whether select patient populations may benefit from de-escalation rather than escalation of systemic therapy for kidney cancer.
Evaluation of the early use of norepinephrine in major abdominal surgery on medical and surgical postoperative complications: study protocol for a randomised controlled trial (EPON STUDY)
Background
Post-induction anaesthesia often promotes intraoperative hypotension (IOH) that can worsen postoperative outcomes. This study aims to assess the benefit of norepinephrine versus ephedrine at the induction of anaesthesia to prevent postoperative complications following major abdominal surgery by preventing IOH.
Methods and analysis
The EPON STUDY is a prospective single-centre randomised controlled trial with the planned inclusion of 500 patients scheduled for major abdominal surgery at the Amiens University Hospital. The inclusion criteria are patients aged over 50 years weighing more than 50 kg with an American Society of Anesthesiologists physical status score of ≥2 undergoing major abdominal surgery under general anaesthesia. Patients are allocated either to the intervention group (n=250) or the standard group (n=250). In the intervention group, the prevention of post-induction IOH is performed with norepinephrine (dilution to 0.016 mg/mL) using an electric syringe pump at a rate of 0.48 mg/h (30 mL/h) from the start of anaesthesia and then titrated to achieve the haemodynamic target. In the control group, the prevention of post-induction IOH is performed with manual titration of ephedrine, with a maximal dose of 30 mg, followed by perfusion with norepinephrine. In both groups, the haemodynamic target to maintain is a mean arterial pressure (MAP) of 65 mm Hg or 70 mm Hg for patients with a medical history of hypertension. An intention-to-treat analysis will be performed. The primary outcome is the Clavien–Dindo score assessed up to 30 days postoperatively. The secondary endpoints are the length of hospital stay and length of stay in an intensive care unit/postoperative care unit; postoperative renal function; postoperative cardiovascular, respiratory, neurological, haematological and infectious complications at 1 month; and volume of intraoperative vascular filling and mortality at 1 month.
Ethics and dissemination
Ethical approval was obtained from the committee of protection of the persons of Ile de France in May 2021 (number 21 05 41). The authors will be involved in disseminating the research findings (through attending conferences and co-authoring papers). The results of the study will be disseminated via peer-reviewed publications and presentations at national and international conferences.
Trial registration number
NCT05276596.