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Functional dyspepsia (FD) is a gut-brain axis disorder characterized by postprandial fullness, early satiety, bloating and/or epigastric pain, which are presumed to originate in the gastroduodenal tract. While the international recommendations in the Rome IV consensus require endoscopy to rule out an organic condition before establishing a diagnosis of FD, international guidelines recommend that, in the absence of risk factors, patient management be initiated at the primary care level by establishing Helicobacter pylori infection status, with eradication when positive, followed by empiric therapy with proton pump inhibitors and/or prokinetics, and that endoscopy be reserved for patients refractory to said measures. Second-line therapy includes neuromodulating agents, among which tricyclic antidepressants and atypical antipsychotics such as levosulpiride stand out.
View Article and Find Full Text PDFSociety of American Gastrointestinal and Endoscopic Surgeons guidelines development: Clinical Practice Guideline Update Standard Operating Procedure.
Surg Endosc
January 2025
Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Introduction: The SAGES Guidelines Committee creates evidence-based clinical practice guidelines (CPGs). Updates which incorporate new evidence into the guidelines are necessary to maintain relevance for clinical use. A description of our standard operating procedure for this process is described here, which contributes to SAGES' commitment to producing high-quality clinical recommendations.
View Article and Find Full Text PDFProphylactic pharmacological interventions against perioperative respiratory adverse events in children undergoing noncardiac surgery: a systematic review and meta-analysis.
J Anesth
January 2025
Department of Anesthesiology, the First Affiliated Hospital, Sun Yat-sen University, No.58, Zhongshan 2Nd Road, Guangzhou, 510080, China.
Purpose: Perioperative respiratory adverse event (PRAE) is one of the most common complications in pediatric anesthesia. We aimed to evaluate the efficacy of perioperative pharmacological interventions to prevent the development of PRAE in children undergoing noncardiac surgery.
Methods: PubMed, Embase, Cochrane Library and ClinicalTrials.
The Evidence-Based Medicine Management of Endometriosis Should Be Updated for the Limitations of Trial Evidence, the Multivariability of Decisions, Collective Experience, Heuristics, and Bayesian Thinking.
J Clin Med
January 2025
Department of Operative Gynecology, Federal State Budget Institution V. I. Kulakov Research Centre for Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, 117997 Moscow, Russia.
: The diagnosis and treatment of endometriosis should be based on the best available evidence. Emphasising the risk of bias, the pyramid of evidence has the double-blind, randomised controlled trial and its meta-analyses on top. After the grading of all evidence by a group of experts, clinical guidelines are formulated using well-defined rules.
View Article and Find Full Text PDFGastric Intestinal Metaplasia in Children and Adolescents Is Reversible upon Reaching Adulthood-Results from a Long-Term Cohort Study.
Cancers (Basel)
January 2025
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
Background/objectives: Gastric intestinal metaplasia (GIM) is considered an irreversible preneoplastic precursor for gastric adenocarcinoma in adults. However, its significance in children and the long-term outcome remain poorly understood.
Methods: All children diagnosed with GIM between 2000 and 2020 were identified at a large tertiary referral centre.
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