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European guidelines for the diagnosis, treatment and follow-up of breast lesions with uncertain malignant potential (B3 lesions) developed jointly by EUSOMA, EUSOBI, ESP (BWG) and ESSO.

INTRODUCTION: Breast lesions of uncertain malignant potential (B3) include atypical ductal and lobular hyperplasias, lobular carcinoma in situ, flat epithelial atypia, papillary lesions, radial scars and fibroepithelial lesions as well as other rare miscellaneous lesions. They are challenging to categorise histologically, requiring specialist training and multidisciplinary input. They may coexist with in situ or invasive breast cancer (BC) and increase the risk of subsequent BC development. Management should focus on adequate classification and management whilst avoiding overtreatment. The aim…

Cost-effectiveness analysis of different screening and diagnostic strategies for sexually transmitted infections and bacterial vaginosis in women attending primary health care facilities in Cape Town.

BACKGROUND: Genital inflammation associated with sexually transmitted infections (STIs) and bacterial vaginosis (BV) is considered a key dri … diagnosed with an STI(s) and/or BV and provided treatment. This strategy resulted in lower rates of overtreatment compared to syndromic management, but higher rates compared to etiological diagnosis using nucleic acid amplification tests and microscopy. However, following a GIFT positive test with etiological diagnosis prior to treatment did not increase the ef …

Sclerosing polycystic adenosis of the submandibular gland: Two case reports.

BACKGROUND: Sclerosing polycystic adenosis (SPA) is a rare disease of salivary glands, similar to fibrocystic disease of the breast. It occu … ld be familiar with the characteristics of SPA in the submandibular gland to avoid misdiagnosis and overtreatment.

Screening for depression in children and adolescents: a protocol for a systematic review update.

BACKGROUND: Major depressive disorder is common, debilitating, and affects feelings, thoughts, mood, and behaviors. Childhood and adolescenc … ance use, school performance, lost time at work, or school), false-positive results, overdiagnosis, overtreatment, labeling, and other harms such as those arising from treatment. We will search MEDLINE, Embase, PsycINFO, CINAHL, the Cochrane Library, and grey literature sources. Two reviewers will independently screen the titles and abstracts using the liberal …

How could metabolomics change pediatric health?

In the last years, 'omics' technologies, and especially metabolomics, emerged as expanding scientific disciplines and promising technologies … performing the best therapeutic approach, potentially predicting the therapy response and avoiding overtreatments. Moreover, the application of metabolomics in nutrition could provide significant information on the best nutrition regimen, optimal infantile growth and even in the characterization and improvement of commercial products' composition.These are onl …

[Treatment of Urinary incontinence associated with genital prolapse: Clinical practrice guidelines].

INTRODUCTION: Prolapse and urinary incontinence are frequently associated. Patente (or proven) stress urinary incontinence (SUI) is defined … eat up to 60% of the masked SUI. Concomitant treatment of the hidden IUE therefore exposes again to overtreatment and a specific overactive bladder and dysuria morbidity. CONCLUSION: In case of overt or hidden urinary incontinence, concomitant treatment of SUI and prolapse reduces the risk of postoperative SUI but exposes to a specific overactive bladder and d …

Intrapartum fever at term: diagnostic markers to individualize the risk of fetal infection: a review.

UNLABELLED: Intrauterine infection is a serious complication during labor at term and is associated with adverse neonatal outcome. Early and accurate diagnosis is of great concern for both obstetrician and pediatrician with the use of current diagnostics. Clinical symptoms are often regarded as the main sign of intrauterine infection but this approach is highly unreliable and leads to both under- and overtreatment. Currently, no distinct fetal heart rate (FHR) patterns have been found that reliably identify neonates with intrauterine infection. Using a systematic literature search, this articl…

The natural history of locally advanced primary breast carcinoma and metastatic disease.

Breast cancer is considered a chronic disease in most women. This belief is based on natural history data that suggest that some patients wi … e know that patients may suffer a painful death without intervention, and we are aware as well that overtreatment may impart untoward symptomatic consequences in the final stages of life when quality is of paramount importance to both the patient and the family.

Comparison of a mean arterial pressure alarm to the hypotension prediction index in preventing intraoperative hypotension in elective moderate- to high-risk non-cardiac surgical patients: a study protocol for a blinded, parallel, randomized controlled trial with a non-inferiority framework.

BACKGROUND: Intraoperative hypotension is common in surgical patients and associated with an increased risk for acute kidney injury, myocard … interventions could vary between participants and groups. Contrarily, early treatment could lead to overtreatment. TRIAL REGISTRATION: Overview of Medical research in the Netherlands (OMON), NL-OMON53215, registered on 20-09-2023, last updated on 30-01-2025, https://onderzoekmetmensen.nl/nl/trial/53215 .

Management of Shoulder Pain in Primary Care: A Review.

IMPORTANCE: Shoulder pain is a common and disabling condition most often managed in primary care. This review provides an evidence-based upd … es often do not correlate with symptoms, rarely alter management, and may lead to overdiagnosis and overtreatment. Specialist referral should be reserved for suspected serious pathology, such as infection, malignant neoplasm, fracture, or dislocation; significant functional or neurologic deficit; features suggestive of systemic inflammatory disease; or persiste …

Blood leukocytes as a non-invasive diagnostic tool for thyroid nodules: a prospective cohort study.

BACKGROUND: Thyroid nodule (TN) patients in China are subject to overdiagnosis and overtreatment. The implementation of existing technologies such as thyroid ultrasonography has indeed contributed to the improved diagnostic accuracy of TNs. However, a significant issue persists, where many patients undergo unnecessary biopsies, and patients with malignant thyroid nodules (MTNs) are advised to undergo surgery therapy. METHODS: This study included a total of 293 patients diagnosed with TNs. Differential methylation haplotype blocks (MHBs) in blood leukocytes between MTNs and benign thyroid nodu…

The ADEM2 project: early pathogenic mechanisms of preschool wheeze and a randomised controlled trial assessing the gain in health and cost-effectiveness by application of the breath test for the diagnosis of asthma in wheezing preschool children.

BACKGROUND: The prevalence of asthma-like symptoms in preschool children is high. Despite numerous efforts, there still is no clinically available diagnostic tool to discriminate asthmatic children from children with transient wheeze at preschool age. This leads to potential overtreatment of children outgrowing their symptoms, and to potential undertreatment of children who turn out to have asthma. Our research group developed a breath test (using GC-tof-MS for VOC-analysis in exhaled breath) that is able to predict a diagnosis of asthma at preschool age. The ADEM2 study assesses the improveme…

DNA Methylation Analysis to predict Regression of high-grade anal Intraepithelial Neoplasia in HIV+ men (MARINE): a cohort study protocol.

INTRODUCTION: Anal cancer precursors, or high-grade anal intraepithelial neoplasia (HGAIN), are highly prevalent in HIV-seropositive (HIV+) men who have sex with men (MSM). Around 30% of lesions regress within 1 year, but current histopathological assessment is unable to distinguish between HGAIN likely to regress and HGAIN likely to persist or progress to cancer. We aim to assess if host cell DNA methylation markers can predict regression of HGAIN, thus determining the need for immediate treatment or active surveillance. This could reduce overtreatment and the associated anal and psycho-sexua…

Dengue fever in a patient with severe haemophilia: a case report.

BACKGROUND: Dengue fever is the most rapidly spreading mosquito-borne viral disease in the world. Haemophilia A is the commonest inherited b … nd/or factor correction, in order to prevent dengue-related morbidity and mortality whilst avoiding overtreatment. In endemic areas it is advisable that such patients seek early medical help in the event of an acute fever.

EAU guidelines on vesicoureteral reflux in children.

CONTEXT: Primary vesicoureteral reflux (VUR) is a common congenital urinary tract abnormality in children. There is considerable controversy … with a recent focus on minimally invasive techniques. CONCLUSIONS: While it is important to avoid overtreatment, finding a balance between cases with clinically insignificant VUR and cases that require immediate intervention should be the guiding principle in the management of children presenting with VUR.

Reduction in physician reimbursement and use of hormone therapy in prostate cancer.

BACKGROUND: Use of androgen suppression therapy (AST) in prostate cancer increased more than threefold from 1991 to 1999. The 2003 Medicare … e therapy for prostate cancer, decreased physician reimbursement was associated with a reduction in overtreatment without a reduction in needed services.

Characteristics of airway inflammation and bronchodilator reversibility in COPD: a potential guide to treatment.

STUDY OBJECTIVES: The management of stable patients with COPD depends on the severity of symptoms and airflow limitation. Regarding inflammation, corticosteroids are the only medications that are recommended for use, and only under restricted circumstances. Corticosteroids tend to undertreat or overtreat patients with COPD when only clinical manifestations and the findings of simple spirometry are considered. Accordingly, our aim was to survey the characteristics of airway inflammation in stable COPD patients, and to assess the interrelations among inflammatory cells, inflammatory mediators, b

Comprehensive biochemical insights into derivatives of PSA and glycosylation-specific changes in PSA: role in diagnosis and management of prostate cancer.

BACKGROUND: Prostate cancer (PCa) is the most commonly diagnosed cancer in men worldwide, and prostate-specific antigen (PSA) test is curren … hat solely simple testing of serum PSA levels to diagnose PCa leads to widespread overdiagnosis and overtreatment. This is because simple PSA test has certain limitations, including lack of specificity, elevation in Benign Prostatic Hyperplasia (BPH) and inability to detect a significant number of PSA-negative tumors. Additionally, serum PSA levels do not direc …

Частота обычного кровотечения у пациентов с хроническими почечными заболеваниями: обзор с целью информирования о необходимости ухода.

ЦЕЛЬ РАССМОТРЕНИЯ: Лица, страдающие хроническими заболеваниями почек, лица, проходящие диализную терапию, а также лица, имеющие как почки коренного происхождения, так и почки трансплантации, проходят плановое тестирование крови для регулярного наблюдения и мониторинга ЧКД и его осложнений. Не хватает доказательств, подтверждающих установленную частотность и полезность испытаний, которые в значительной степени основаны на исторической практике и экспертном консенсусе. Хотя раннее выявление и корректировка критических лабораторных значений могут привести к улучшению клинических результатов, анал

Совпадение в аннотации оригинала
PURPOSE OF REVIEW: People living with chronic kidney disease (CKD), individuals receiving dialysis therapies, and those with both native and … osts and the environment. Frequent monitoring of highly variable laboratory values may also lead to overtreatment or undertreatment. The purpose of this review is to synthesize the existing evidence pertaining to current blood testing frequencies across the spectrum of patients with CKD to fully inform the appropriateness of care. SOURCES OF INFORMATION: The s …

Bridging the gap in breast cancer screening: the role of primary care and person-centered care in a Polish regional survey.

BACKGROUND: Breast cancer mortality in Poland shows a concerning upward trend, contrasting with the declines seen across much of Europe. Whi … heir FP. Furthermore, only one-third of participants were informed about the risks of overdiagnosis/overtreatment, highlighting a gap in the informed consent process. CONCLUSIONS: There is a significant discrepancy between high lifetime screening rates and the depth of patient clinical literacy and informed choice. Primary care centers represent a critical, yet …