AGA Clinical Practice Update on Incorporating Functional Lumen Imaging Probe Into Esophageal Clinical Practice: Expert Review

The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) is to summarize the available evidence and offer expert best practice advice on the incorporation of the functional lumen imaging probe (FLIP) into clinical practice, specifically its utility in the evaluation of esophageal symptoms, esophageal motor dysfunction, gastroesophageal reflux disease, and eosinophilic esophagitis.

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[Review] The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed obesity management, offering substantial weight loss and metabolic benefits. This review examines their expanding role, evaluating efficacy compared to alternative treatments, emerging indications, ongoing challenges, and future directions. Beyond obesity and type 2 diabetes, the therapeutic potential of GLP-1 RAs extends to a range of conditions such as cardiovascular disease, liver disease, neurodegenerative disease, and substance abuse disorders.

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[Articles] Timing of intravenous iron for treatment of anaemia in surgical patients: a systematic review and network meta-analysis

Our results suggest that postoperative IV iron supplementation reduces transfusion rates, while preoperative supplementation improves haemoglobin recovery. Clinicians may choose either strategy in an individualised, patient-centered manner. These conclusions should be interpreted with caution due to heterogeneity among included studies, limited data for subgroup analyses, and the absence of direct comparisons between preoperative and postoperative approaches.

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[Review] Respiratory syncytial virus hospitalization costs, rates, and seasonality in Asia: a systematic review and meta-analysis

This study highlights the significant burden of RSV in Asia, particularly among young children, and highlights substantial variation in seasonality and economic impact across the region. The findings emphasize the need for region-specific RSV data to inform targeted prevention strategies and healthcare resource allocation. High heterogeneity in cost estimates suggests variability in healthcare access and economic conditions, warranting further investigation.

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Tumori: l'immunoterapia pre-intervento rivoluziona le cure. Convegno a Napoli [Oncologia-Ematologia]

Dal melanoma al tumore del polmone, dal cancro al seno triplo negativo a quello del colon-retto e della vescica: sono sempre più numerosi i tumori per cui la somministrazione dell’immunoterapia neoadiuvante, cioè del trattamento prima dell’intervento chirurgico, mostra evidenze di maggiore efficacia. Questa nuova evoluzione dell’immunoterapia è al centro della seconda edizione di “I.N.N.O.VA.T.E. – International Neoadjuvant Immunotherapy Across Cancers”, al via oggi, e fino a domani, a Napoli.

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Microbiota intestinale nella fibromialgia: un ruolo emergente? [Dolore]

Una recente review pubblicata su Clinical and Experimental Rheumatology ha messo in luce le nuove evidenze del possibile coinvolgimento del microbiota intestinale nella patogenesi della fibromialgia. Gli autori, tra cui compaiono due esperti italiani il prof. Piercarlo Sarzi Puttini e la prof.ssa Laura Bazzichi, sottolineano che in attesa di studi più approfonditi su tale coinvolgimento è importante adottare un approccio olistico che tengo conto anche della valutazione nutrizionale e di eventuali disbiosi.

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[Review] Measurable residual disease in hematologic malignancies: a biomarker in search of a standard

Over the past decade, measurable residual disease (MRD) has emerged as a critical tool for detecting and monitoring a variety of cancers, but particularly hematologic malignancies. The rapid adaptation of this novel approach to monitoring disease status is intuitively appealing: it offers significantly greater sensitivity than traditional methods for detecting the small population of malignant cells that persist after treatment, and which are undetectable by standard approaches such as monitoring abnormalities on radiographic scans or assessing morphologic or karyotypic changes from bone marrow sampling.

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Immunomodulatory therapies in community-acquired pneumonia: a protocol for a systematic review and network meta-analysis

Introduction
Community-acquired pneumonia is the leading global cause of infection-related death. A subset of patients with pneumonia develops aberrant immune responses, resulting in harmful inflammation, tissue damage and significant mortality. Immunomodulatory therapies aim to blunt this dysregulated immune response and reduce resultant injury. No consensus exists on the use or impacts of immunomodulatory therapies in the management of community-acquired pneumonia. This protocol describes the methods we will use to undertake a systematic review and network meta-analysis of the effects of immunomodulatory therapies on the mortality of patients with community-acquired pneumonia.

Methods
We will undertake a systematic review and network meta-analysis investigating the use of immunomodulatory therapies in community-acquired pneumonia. Our protocol has been developed and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines and prospectively registered with PROSPERO (CRD42024565301). The primary objectives of this work are to compare the impact of immunomodulatory therapies on 28-day and 90-day mortality in adult patients admitted to hospital with a primary diagnosis of community-acquired pneumonia. The secondary objectives of this work are to identify any differences in the effectiveness of these immunomodulatory therapies in managing community-acquired pneumonia of differing aetiology and severity.
We will conduct a literature search of Medline, Embase, Scopus, Web of Science and Global Health for all relevant articles until 30 June 2024. All observational, interventional and epidemiological studies published in English will be included, and each type of study design will be examined separately. All studies will have their titles and abstracts independently screened by two reviewers, followed by a full article eligibility review and data extraction. A third reviewer will adjudicate any disagreements. Data extracted will include, but not be limited to, the study design, country in which it was undertaken, patient characteristics (eg, age, sex, cause of CAP, severity of CAP), details regarding the immunomodulatory therapy and dosing used and the 28-day and 90-day mortality of each study arm.

Analysis
The risk of bias will be assessed using the Risk of Bias in Non-randomised Studies – of Exposure tool for non-randomised studies and the Cochrane Risk of Bias 2 tool for randomised control trials. The quality of evidence will be evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations for network meta-analysis framework. A quantitative synthesis of data is planned for 28-day and 90-day mortality rates.
We will fit a random-effects network meta-analysis model that includes random effects for between-study heterogeneity and for inconsistency. This will be done using the metafor package for R. We will use a contrast-based approach, modelling estimated treatment effects using reference treatments. In the case of the primary objective, this will be the log odds ratio (OR) of mortality in one treatment compared with another.
Each type of study design will be examined separately. Treatments using the same immunotherapy at different doses may be grouped if appropriate.

Ethical approval and dissemination
This will be a systematic review of published literature; therefore, ethical approval is not required. To ensure communication of our findings, we will publish our results in a peer-reviewed journal and present our findings at appropriate local, national and international meetings.

PROSPERO registration number
CRD42024565301.

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[Articles] Global outbreaks of respiratory syncytial virus infections from 1960 to 2025: a systematic review and meta-analysis

RSV outbreaks have contributed significantly to global morbidity since the 1960s, with increasing reports over time. While the CFRs have decreased, they remain high in certain subgroups based on age, genotype, and outbreak setting. The pooled attack rate remains substantial, particularly in healthcare settings involving RSV-B genotypes and among immunosuppressed populations. This meta-analysis underscores the importance of targeted vaccination and treatment strategies for controlling RSV outbreaks worldwide in the future.

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Cancro della prostata non metastatico ormono-sensibile, Aifa approva  la rimborsabilità di enzalutamide. Cambia il paradigma di cura [Italia]

L’Agenzia Italiana del Farmaco (Aifa) ha riconosciuto la rimborsabilità di un’ulteriore indicazione terapeutica per enzalutamide, sulla base dei risultati dello studio di Fase 3 EMBARK. Con questa autorizzazione enzalutamide diventa il primo ed unico inibitore del segnale del recettore degli androgeni che ha ottenuto la rimborsabilità per il trattamento di uomini adulti con cancro della prostata non metastatico ormono-sensibile (nmHSPC) con recidiva biochimica (BCR) ad alto rischio non idonei alla radioterapia di salvataggio

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Development and preliminary evaluation in community mental health teams of a cervical screening informed-choice tool for women with severe mental illness in England: a mixed-method study

Objectives
Women with severe mental illness (SMI) face barriers to cervical cancer screening, leading to lower participation and poorer outcomes. This research aimed to develop and test an informed-choice tool to help women with SMI make informed decisions about screening attendance.

Design
The tool was developed using a realist review of physical health interventions and a systematic review of informed-choice tools for people with SMI. A mixed-methods approach informed its development. Usability and acceptability were assessed through semistructured interviews and the think-aloud method with service users (n=18), clinicians (n=16) and key informants. A preliminary proof-of-concept (n=25) evaluated the impact on decisional conflict—the uncertainty around making value-sensitive choices.

Setting and participants
Conducted in two National Health Service (NHS) Mental Health Trusts (urban and rural). Participants included women with SMI accessing secondary mental healthcare, clinicians and service user groups. A key informants’ group guided clinical content.

Intervention
A cervical screening informed-choice leaflet and an accompanying video.

Results
The tool was usable and acceptable, especially for women overdue or never screened. It may reduce decisional conflict and increase screening uptake, potentially improving survival. An National Institute for Health and Care Research (NIHR)-funded feasibility trial (Improving uptake of cervical screening in people with severe mental illness (OPTMISE)) is underway. The current UK government guidance on Support for people who find it hard to attend cervical screening due to having a mental health condition or having experienced trauma or abuse is based on this research.

Conclusions
Future research may involve further assessments of the real-world impact of the tool and its adaptation to other health-related decisions.

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