Consensus statement on the management of urticaria

This consensus statement was developed by Special Interest Group - Urticaria (IADVL). Urticaria, a heterogeneous group of diseases, often cannot be recognized by its morphology. Due to non-specific and non-affordable diagnosis, management of urticaria, especially chronic urticaria, is very challenging. This guideline includes definition, causes, classification and management of urticaria. Urticaria has a profound impact on the quality of life and causes immense distress to patients, necessitating effective treatment. One approach to manage urticaria is identification and elimination of the underlying cause(s) and/or eliciting trigger(s), while the second one is treatment aimed at providing symptomatic relief. This guideline recommends use of second-generation non-sedating H1 antihistamines as the first-line treatment. The dose can be increased up to four times to meet the expected results. In case patients still do not respond, appropriate treatment options can be selected depending on the cost.     

Methylmercury exposure assessment using dietary and biomarker data among frequent seafood consumers in France CALIPSO study

BACKGROUND: Seafood is considered by toxicologists as the main source of methylmercury (MeHg), but little data is available concerning contamination of seafood and MeHg status of French frequent consumers. OBJECTIVES: The objectives were to assess food exposure and biomarker of exposure of MeHg from a group of frequent consumers of seafood. METHODS: Two approaches to exposure assessment were used: the currently used food intake and the biomarker of exposure. A validated food frequency questionnaire (FFQ) was used to assess seafood consumptions for 80 products of 385 frequent consumers aged 18 and over in four French coastal areas. Seafood samples were collected in each region considering preservation methods and supply habits according to a total diet study sampling. Food samples were analyzed for MeHg. Exposure was assessed by combining consumptions with contamination data. Whole blood samples were collected from the volunteers and analyzed for MeHg. RESULTS: The mean dietary exposure to MeHg or weekly intake (WI FFQ) was 1.51+/-1.17 microg/kg bw/wk. Thirty-five percent of the subjects exceed the Joint Expert Committee on Food Additives (JECFA) provisional tolerable weekly intake (PTWI), whereas the use of the biological results with the JECFA/Environmental Protection Agency (EPA) one-compartment pharmacokinetic model to calculate weekly intake (WI PKM) shows that only 2% of subjects exceed the PTWI. The mean of the individual ratios WI FFQ/WI PKM is 4.3 and the higher the WI FFQ and the blood MeHg level, the lower is the ratio, close to 1-2. CONCLUSIONS: These analyses support the assumption that the calculated dose of methylmercury is overestimated with the FFQ-based method used in this study. Since FFQ are commonly used in risk assessments, the overestimate of dose is public health protective and this finding is somewhat reassuring from a public health point of view, especially since the JECFA or EPA have applied uncertainty factors of 3.2 or 3, respectively, to take into account the inter-individual pharmacokinetic variability.     

人工流产围手术期下生殖道感染筛查和诊治的中国专家共识（2022年版）

中国卫生健康年鉴数据显示,近年来我国人工流产总数平均每年大约 900多万例,约占全球的1/6 ［1］。人工流产围手术期下生殖道感染的发生率也越来越引起重视。术前存在下生殖道感染不仅会延误最佳治疗时机,而且也会增加手术并发症风险,不利于子宫恢复。下生殖道感染多无明显症状或缺乏特异性症状,若人工流产术前未及时发现和有效治疗,人工流产实施宫腔侵入性操作过程中的下生殖道病原体上行感染,将会造成一些严重疾病及相关后遗症,如盆腔炎症性疾病（pelvic inflammatory disease,PID）、子宫颈和（或）宫腔粘连、输卵管阻塞、慢性盆腔痛及继发不孕等,再次妊娠可能发生如异位妊娠、自然流产及早产等不良结局,严重损害女性生育能力及身心健康［2］。     

U.K. consensus statement on the use of extracorporeal photopheresis for treatment of cutaneous T-cell lymphoma and chronic graft-versus-host disease

Extracorporeal photopheresis (ECP) has been used for over 30 years in the treatment of erythrodermic cutaneous T-cell lymphoma (CTCL) and over 20 years for chronic graft-versus-host disease (cGVHD). The lack of prospective randomized trials has led to different centres having different patient selection criteria, treatment schedules, monitoring protocols and patient assessment criteria. ECP for CTCL and cGVHD is available only at six specialized centres across the U.K. In the recent Improving Outcomes Guidance the National Institute for Health and Clinical Excellence endorsed the use of ECP for CTCL and because of the complexity of treatment supported its use in specialized centres and also suggested the need for expansion of this service. In 2005 consultants and senior nurses from all U.K. sites and from Scandinavia formed a Photopheresis Expert Group. This group's first aim was to produce a consensus statement on the treatment of CTCL and cGVHD with ECP using evidence-based medicine and best medical practice, in order to standardize ECP eligibility, assessment and treatment strategies across the U.K.     

内行患者计划的实施对永久性结肠造口患者的自我效能和自我管理的影响

目的 探讨内行患者计划的实施对永久性结肠造口患者的自我效能和自我管理的影响.方法 采用造口相关自我效能问卷和自我管理问卷,分别对48例永久性结肠造口患者在参加内行患者计划课程前后进行问卷调查,比较参加课程前后的自我效能和自我管理的得分情况.结果 在参加内行患者计划课程4周后,患者的自我效能总分及自我管理总分都较参加课程前有显著提高.结论 内行患者计划的实施可以有效地提高永久性结肠造口患者的自我效能和自我管理.     

Computer-generated tailored feedback letters for smoking cessation: theoretical and empirical variability of tailoring

Purpose

This study examines tailored feedback letters of a smoking cessation intervention that is conceptually based on the transtheoretical model, from a content-based perspective.

Methods

Data of 2 population-based intervention studies, both randomized controlled trials, with total N = 1044 were used. The procedure of the intervention, the tailoring principle for the feedback letters, and the content of the intervention materials are described in detail. Theoretical and empirical frequencies of unique feedback letters are presented.

Results

The intervention system was able to generate a total of 1040 unique letters with normative feedback only, and almost half a million unique letters with normative and ipsative feedback. Almost every single smoker in contemplation, preparation, action, and maintenance had an empirically unique combination of tailoring variables and received a unique letter. In contrast, many smokers in precontemplation shared a combination of tailoring variables and received identical letters.

Conclusion

The transtheoretical model provides an enormous theoretical and empirical variability of tailoring. However, tailoring for a major subgroup of smokers, i.e. those who do not intend to quit, needs improvement. Conceptual ideas for additional tailoring variables are discussed.     

Is face-only photographic view enough for the aesthetic evaluation of breast cancer conservative treatment?

The breast cancer conservative treatment. cosmetic results (BCCT.core) is a new software tool created for the automatic and objective evaluation of the aesthetic result of BCCT. It makes use of a face-only photographic view of each patient and might thus have been considered insufficient for an accurate evaluation, as others have used multiple views of each patient. The purpose of this work is to compare the performance of the BCCT.core (using face-only views) with a subjective expert analysis using both the face-only and four-view assessment. Photographs in four-views of 150 patients, were evaluated by a panel of experts and a consensus classification was obtained. The agreement between the consensus and the BCCT.core (face-only view) was calculated using the kappa (k) and weighted kappa (wk) statistics. Face-only views, of the same 150 patients, were subsequently sorted out in a different order and sent for individual evaluation by three specialists from the previous panel of experts. The individual agreement between the face-only view and the four-view evaluation by each of the three experts and the consensus was calculated using the same methods. Obtained results were compared to the BCCT.core performance. The software obtained a moderate agreement with the consensus (k = 0.57; wk = 0.68). The highest value of agreement, from the three experts, between the four-view evaluation and the consensus was identical to the software agreement (k = 0.55; wk = 0.67). In the face-only view experiment, the highest value of agreement between the experts and the consensus was only fair (k = 0.37; wk = 0.54). Performance of the software was thus considered equal to that obtained by experts using a four-view evaluation.     

美国妇产科医师学会和母胎医学会《35岁及以上高龄孕妇妊娠管理（2022版）》专家共识解读#br#

国际妇产科联盟（International Federation of Gynecology and Obstetrics,FIGO）将分娩年龄≥35岁的妊娠定义为高龄妊娠,此时期的孕产妇称之为高龄孕产妇（advanced maternal age,AMA）。数据显示,全球孕妇平均年龄持续上升,引起了人们对高龄孕妇妊娠结局的关注。大量研究结果显示,高龄孕妇母胎不良妊娠结局风险增加,即使在没有其他合并症的健康人群中也是如此。     

苗医弩药针疗法治疗癌性疼痛技术规范专家共识

癌性疼痛（癌痛）是各种恶性肿瘤常见的主要并发症之一,严重影响患者的生命质量,有效控制或减轻癌症引起的、治疗过程产生的疼痛,使更多的癌痛患者获得治疗和关心,也成为当今医学所关切的重要问题。苗医弩药针疗法经临床研究证实,对于癌性疼痛具有较好的镇痛效果、安全有效且易于操作,但缺乏严谨的规范和循证医学证据。本共识规定了苗医弩药针疗法的定义、基本操作流程和要点,规定了弩药针疗法治疗癌性疼痛的苗药处方、器具准备、基本操作方法、操作程序、注意事项等内容。     

Consensus on the Diagnosis and Treatment of Vitiligo in China (2021 Revision) #

Vitiligo is a common depigmented skin disease that negatively affects the physical and mental health of patients. The 2018 version of the Vitiligo Treatment Con...