| 1. |
- Lazarus, Jeffrey V., et al.
(författare)
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A multinational Delphi consensus to end the COVID-19 public health threat
- 2022
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687.
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Tidskriftsartikel (refereegranskat)abstract
- Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.
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| 2. |
- Abreu-Mendes, Pedro, et al.
(författare)
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Myofascial Pelvic Pain : Best Orientation and Clinical Practice. Position of the European Association of Urology Guidelines Panel on Chronic Pelvic Pain
- 2023
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Ingår i: European Urology Focus. - : Elsevier. - 2405-4569. ; 9:1, s. 172-177
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: Despite the high prevalence of a myofascial pain component in chronic pelvic pain (CPP) syndromes, awareness and management of this component are lacking among health care providers.OBJECTIVE: To summarize the current state of the art for the management of myofascial pain in chronic primary pelvic pain syndromes (CPPPS) according to scientific research and input from experts from the European Association of Urology (EAU) guidelines panel on CPP.EVIDENCE ACQUISITION: A narrative review was undertaken using three sources: (1) information in the EAU guidelines on CPP; (2) information retrieved from the literature on research published in the past 3 yr on myofascial pelvic pain; and (3) expert opinion from panel members.EVIDENCE SYNTHESIS: Studies confirm a high prevalence of a myofascial pain component in CPPPS. Examination of the pelvic floor muscles should follow published recommendations to standardize findings and disseminate the procedure. Treatment of pelvic floor muscle dysfunction and pain in the context of CPP was found to contribute to CPP control and is feasible via different physiotherapy techniques. A multidisciplinary approach is the most effective.CONCLUSIONS: Despite its high prevalence, the myofascial component of CPP has been underevaluated and undertreated to date. Myofascial pain must be assessed in all patients with CPPPS. Treatment of the myofascial pain component is relevant for global treatment success. Further studies are imperative to reinforce and better define the role of each physiotherapy technique in CPPPS.PATIENT SUMMARY: Pain and inflammation of the body's muscle and soft tissues (myofascial pain) frequently occurs in pelvic pain syndromes. Its presence must be evaluated to optimize management for each patient. If diagnosed, myofascial pain should be treated.
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| 3. |
- Betti, S. K., et al.
(författare)
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Near-infrared Accretion Signatures from the Circumbinary Planetary-mass Companion Delorme 1 (AB)b
- 2022
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Ingår i: Astrophysical Journal Letters. - : American Astronomical Society. - 2041-8205 .- 2041-8213. ; 935:1
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Tidskriftsartikel (refereegranskat)abstract
- Accretion signatures from bound brown dwarf and protoplanetary companions provide evidence for ongoing planet formation, and accreting substellar objects have enabled new avenues to study the astrophysical mechanisms controlling the formation and accretion processes. Delorme 1 (AB)b, a ∼30–45 Myr circumbinary planetary-mass companion, was recently discovered to exhibit strong Hα emission. This suggests ongoing accretion from a circumplanetary disk, somewhat surprising given canonical gas disk dispersal timescales of 5–10 Myr. Here, we present the first NIR detection of accretion from the companion in Paβ, Paγ, and Brγ emission lines from SOAR/TripleSpec 4.1, confirming and further informing its accreting nature. The companion shows strong line emission, with Lline ≈ 1–6 × 10−8 L⊙ across lines and epochs, while the binary host system shows no NIR hydrogen line emission (Lline < 0.32–11 × 10−7 L⊙). Observed NIR hydrogen line ratios are more consistent with a planetary accretion shock than with local line excitation models commonly used to interpret stellar magnetospheric accretion. Using planetary accretion shock models, we derive mass accretion rate estimates of Ṁpla∼3–4 × 10−8 MJ yr−1, somewhat higher than expected under the standard star formation paradigm. Delorme 1 (AB)b's high accretion rate is perhaps more consistent with formation via disk fragmentation. Delorme 1 (AB)b is the first protoplanet candidate with clear (signal-to-noise ratio ∼5) NIR hydrogen line emission.
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| 4. |
- Parsons, Brian A., et al.
(författare)
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The Benefits and Harms of Botulinum Toxin-A in the Treatment of Chronic Pelvic Pain Syndromes : A Systematic Review by the European Association of Urology Chronic Pelvic Pain Panel
- 2022
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Ingår i: European Urology Focus. - : Elsevier BV. - 2405-4569. ; 8:1, s. 320-338
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Forskningsöversikt (refereegranskat)abstract
- Chronic pelvic pain (CPP) is chronic or persistent pain perceived in structures related to the pelvis of men and women. Patients with CPP may have pain refractory to conventional management strategies. Botulinum toxin A (BTX-A) injection is a potential therapeutic option in patients with CPP. Beneficial effects of BTX-A on pain, quality of life, and functional symptoms were seen in patients with certain CPP subtypes, but the current evidence level is too weak to allow recommendations about the use of BTX-A for treating CPP. Therefore, larger-scale, multicentre, well-designed, and appropriately powered randomised controlled trials or prospective case-control studies with longer follow-up periods are needed.
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| 5. |
- Zumstein, Valentin, et al.
(författare)
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The Benefits and Harms of Pharmacological Treatment for Postradiation Pelvic Pain : A Systematic Review by the European Association of Urology Chronic Pelvic Pain Panel with Recommendations for Clinical Practice
- 2023
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Ingår i: European Urology Open Science. - 2666-1691. ; 56, s. 29-38
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Forskningsöversikt (refereegranskat)abstract
- Context: Radiotherapy of the pelvis is a widely used method for the treatment of malignancies, and local complications including pain following pelvic radiation therapy are acknowledged complications. Objective: The primary objective is to assess the clinical effectiveness and safety of pharmacological therapies on postradiation pelvic pain. Evidence acquisition: A systematic review of the use of different pharmacological treatments in the management of post-radiation pelvic pain was conducted (PROSPERO-ID: CRD42021249026). Comprehensive searches of EMBASE, Medline, and Cochrane library were performed for publications between January 1980 and April 2021. The primary outcomes were improvement in pain and adverse events following treatment. The secondary outcomes included quality of life, bowel function, and urinary function. Evidence synthesis: After screening 1514 abstracts, four randomised controlled trials were identified, enrolling 355 patients with bladder and anorectal subtypes of postradiotherapy chronic pelvic pain (CPP). A narrative synthesis was performed as heterogeneity of included studies precluded a meta-analysis. A single study reported a significant reduction in pain after 6 mo in patients with bladder pain syndrome treated with hyaluronic acid or hyperbaric oxygen. Anorectal pain was reported to be reduced by the application of 4% formalin, but the use of hyperbaric oxygen in postradiotherapy anorectal pain remains controversial. Adverse event reporting was generally poor. Studies looking at medications used routinely in guidelines for neuropathic pain, such as gabapentin, pregabalin, amitriptyline, and duloxetine, were absent or of poor quality when it came to postradiation pelvic pain. Conclusions: Beneficial effects of hyperbaric oxygen or formalin on pain, quality of life, and functional symptoms were seen in patients with certain CPP subtypes, but the current evidence level is too weak to allow recommendations about the use of any pharmacological treatment for postradiation pelvic pain. Patient summary: Different pharmacological treatments are used to treat pain after radiotherapy, but current studies are of insufficient quality to determine whether these should be recommended and many chronic pelvic pain subtypes are not covered. Further research is needed.
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