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Levothyroxine supplementation and pregnancy outcomes in women with thyroid disorders: an umbrella review of systematic reviews and meta-analyses of randomized controlled trials.

STUDY QUESTION: Does levothyroxine (LT4) treatment reduce adverse pregnancy outcomes in pregnant women with thyroid dysfunction? SUMMARY AN … ulations, such as SCH patients with positive TPOAb or TSH > 4.0 mU/l, and warns against the risk of overtreatment. The results of this study provide an evidence base for clinical precision intervention. Future studies should address the heterogeneity through standardized large studies, clarify the dose threshold, and evaluate the long-term health effects of LT4 …

The evaluation of maternal systemic thiol/disulphide homeostasis for the short-term prediction of preterm birth in women with threatened preterm labour: a pilot study.

The aim of this study was to investigate maternal systemic thiol/disulphide homeostasis (TDH) for the short-term prediction of preterm birth … length measurement) could be used clinically to triage pregnant women presenting with TPL, avoiding overtreatment, unnecessary hospitalisations and increased medical costs. The future research would be addressed on reducing maternal OS by using new antioxidant treatment strategies to improve perinatal and long-term childhood outcomes.

Adjuvant radiotherapy versus early salvage radiotherapy plus short-term androgen deprivation therapy in men with localised prostate cancer after radical prostatectomy (GETUG-AFU 17): a randomised, phase 3 trial.

BACKGROUND: Adjuvant radiotherapy reduces the risk of biochemical progression in prostate cancer patients after radical prostatectomy. We ai … nary toxicity and erectile dysfunction. A policy of early salvage radiotherapy could spare men from overtreatment with radiotherapy and the associated adverse events. FUNDING: French Health Ministry and Ipsen.

Diagnosis of thyroid cancer using deep convolutional neural network models applied to sonographic images: a retrospective, multicohort, diagnostic study.

BACKGROUND: The incidence of thyroid cancer is rising steadily because of overdiagnosis and overtreatment conferred by widespread use of sensitive imaging techniques for screening. This overall incidence growth is especially driven by increased diagnosis of indolent and well-differentiated papillary subtype and early-stage thyroid cancer, whereas the incidence of advanced-stage thyroid cancer has increased marginally. Thyroid ultrasound is frequently used to diagnose thyroid cancer. The aim of this study was to use deep convolutional neural network (DCNN) models to improve the diagnostic accur…

Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement.

IMPORTANCE: In the United States, the lifetime risk of being diagnosed with prostate cancer is approximately 13%, and the lifetime risk of d … se-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family his …

1995 Volvo Award in clinical sciences. The diagnostic accuracy of magnetic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations.

STUDY DESIGN: This was a prospective study of patients (study group) with symptomatic disc herniations and asymptomatic volunteers (control … d marital status was the best predictive model. With this model, the false-negative rate (potential overtreatment of disc morphology) was reduced by more than half compared with morphologic factors (nerve root compression) alone (22% vs. 11%). CONCLUSIONS: In an age-, sex-, and risk factor-matched group of asymptomatic individuals, disc herniation had a substa …

Multidisciplinary management of mammary Paget's disease: recommendations to optimize oncological and aesthetic outcomes.

We read with interest the article of Francesca Maria Plutino entitled "A peculiar case of Paget's disease of the breast" and would like to m … careful multidisciplinary management is mandatory to optimize the results and minimize the risk of overtreatment 4; an adequate knowledge of the MPD, surgical skills and use of appropriate adjuvant therapies allow to reduce the risk of local recurrence and improve the aesthetic outcomes and patient's quality of life; however, a successful work can be more easi …

Offer of a bandage versus rigid immobilisation in 4- to 15-year-olds with distal radius torus fractures: the FORCE equivalence RCT.

BACKGROUND: Torus (buckle) fractures of the wrist are the most common fractures in children involving the distal radius and/or ulna. It is u … decision tool to determine which children require radiography is an important next step to prevent overtreatment of minor wrist fractures. There is also a need to rationalise interventions for other common childhood injuries (e.g. 'toddler's fractures' of the tibia). TRIAL REGISTRATION: This trial is registered as ISRCTN13955395 and UKCRN Portfolio 39678. FU …

Human Orf: An Under-recognized Entity.

Dear Editor, Orf, also called contagious ecthyma, contagious pustular dermatitis, sore mouth, or scabby mouth, is a highly contagious zoonot … blood tests, histopathology, skin cultures, PCR detection, and electron microscopy) and unnecessary overtreatment. Although a rare entity, the predominant hand involvement in professionals can have significant morbidity that reflects on their productivity and quality of life. This reinforces the need for using appropriate measures to prevent animal-to-human tra …

Comparison of the ESHRE-ESGE and ASRM classifications of Müllerian duct anomalies in everyday practice.

STUDY QUESTION: Does the European Society of Human Reproduction and Embryology-European Society for Gynaecological Endoscopy (ESHRE-ESGE) cl … ASRM. Relative overdiagnosis of septate uterus by ESHRE-ESGE in these cases may lead to unnecessary overtreatment without the expected benefits. The ESHRE-ESGE classification criteria should be redefined due to confusions in the methodology. Until the criteria are revised, septate uterus should not be diagnosed using this classification system and it should not …

The role of misclassification in progression of cervical intraepithelial neoplasia grade 2 during active surveillance: results from a historical cohort.

BACKGROUND: Many countries have recently implemented active surveillance for cervical intraepithelial neoplasia grade 2 as an option in youn … eity of this diagnosis and the importance of accurate diagnosis to minimize both undertreatment and overtreatment. These results highlight the need for individualized, risk-based management strategies for cervical intraepithelial neoplasia grade 2 that integrate virological and cytological factors rather than relying solely on histopathology.

Algorithm-based remote monitoring of heart failure risk data in people with cardiac implantable electronic devices: a systematic review and cost-effectiveness analysis.

BACKGROUND: Heart failure is a clinical syndrome caused by any structural or functional cardiac disorder that impairs the heart's ability to … on, any potential benefits of reduced hospitalisation need to be carefully balanced with chances of overtreatment resulting from alerts. FUTURE WORK: Prospective studies on effectiveness of remote monitoring as well as consideration of patient voice and preferences would facilitate a more complete evaluation of technology benefits. STUDY REGISTRATION: This st …

Clinical, Bone Mineral Density and Spinal Remodelling Responses to Zoledronate Treatment in Chronic Recurrent Multifocal Osteomyelitis.

Background: Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a rare auto-inflammatory condition affecting the growing skeleton. The stan … toring and personalisation of the bisphosphonate dose and regimen are strongly recommended to avoid overtreatment.

Intestinal heterotopic pancreas involved by simultaneous PanIN-2 lesion and endocrine microadenoma: a unique case.

The introduction of mammographic screening in the early 1980's was associated, in the three following decades, with a dramatic increase in t … . Based on the knowledge of today, DCIS could be used to exemplify the notions of overdiagnosis and overtreatment. The final goal of the treatment of DCIS is to prevent invasive breast cancer recurrence. Mortality rate associated with DCIS is very low, being estimated at 1-2 % at 10 years, while patients with DCIS treated by wide local excision with or without …

Transanal Endoscopic Microsurgery Versus Total Mesorectal Excision in ypT0-1 Rectal Cancer After Preoperative Radiochemotherapy: Postoperative Morbidity, Functional Results, and Long-term Oncologic Outcome.

BACKGROUND: In patients with locally advanced extraperitoneal rectal cancer, a multidisciplinary approach represents the standard treatment. However, considering the favorable prognosis in patients with major or complete response, radical surgery might represent overtreatment. OBJECTIVE: This study aimed to evaluate postoperative short-term morbidity, functional outcome, and oncologic long-term outcome in patients with rectal cancer treated with local excision by transanal endoscopic microsurgery or radical surgery and to determine who achieved a complete or major pathological response (ypT0-…

Parallel use of low-complexity automated nucleic acid amplification tests and lateral flow urine lipoarabinomannan assays to detect tuberculosis disease in adults and adolescents living with HIV.

BACKGROUND: Low-complexity automated nucleic acid amplification tests (LC-aNAATs) are molecular World Health Organization (WHO)-recommended … ional patients with tuberculosis at the point-of-care likely outweighs the relatively lower risk of overtreatment of those without tuberculosis. FUNDING: Internal sources: Liverpool School of Tropical Medicine, UK External sources: Foreign, Commonwealth and Development Office (FCDO), UK. Project number 300342-104; WHO, TB Prevention, Diagnosis, Treatment, Care …

Chinese clinical practice guidelines for super minimally invasive surgery of digestive tract tumors.

The mode of organ resection and reconstruction that has been used to treat digestive tract tumors (DTTs) can cure the disease. However, it i … treatment model from "cure first" to "cure-function balance". Its application is expected to reduce overtreatment, improve the patient's quality of life, and provide a framework for future technological iterations and the expansion of indications. It should be continuously optimized with multicenter clinical data and long-term follow-up results to achieve more …

[The Unique Challenges of Treating and Caring for Older Adult Patients With Cancer].

In older age, tissue degeneration, decreased cellular competition, and the declining efficiency of clearance mechanisms lead to higher rates … with cancer (Dale et al., 2012; Extermann, 2000). Age discrimination may lead to undertreatment or overtreatment, affecting patients' functional status and quality of life (Extermann, 2000; Hamaker et al., 2022). Currently, most oncology research relies on either the Eastern Cooperative Oncology Group performance status scale or Karnofsky Performance Scale to …

Editorial: Towards continued and affordable accessibility of innovative drugs: sustainable development and efficient use of medicines.

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… Furthermore, overtreatment strains the environment and healthcare resources, including time, personnel and facilities. … Pharmaceutical companies themselves usually lack incentives to address overtreatment or explore alternative dosing regimens, as this can slow down or jeopardise developmental or business outcomes. …

Interventions for acute otitis externa.

BACKGROUND: Acute otitis externa is an inflammatory condition of the ear canal, with or without infection. Symptoms include ear discomfort, itchiness, discharge and impaired hearing. It is also known as 'swimmer's ear' and can usually be treated successfully with a course of ear drops. OBJECTIVES: To assess the effectiveness of interventions for acute otitis externa. SEARCH STRATEGY: Our search for published and unpublished trials included the Cochrane Ear, Nose and Throat Disorders Group Trials Register; CENTRAL; PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific