98%
921
2 minutes
20
Background: The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014.
Methods: In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as Grade 1 (strong) or Grade 2 (weak) according to the concepts of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.
Results: The 31 CQs covered the six topics: (a) prophylactic treatment, (b) diagnosis, (c) biliary drainage, (d) surgical treatment, (e) chemotherapy, and (f) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded.
Conclusions: This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1002/jhbp.870 | DOI Listing |
J Cardiovasc Surg (Torino)
September 2025
Catheterization Laboratory, Montevergine Clinic, Mercogliano, Avellino, Italy -
Background: Lower extremity arterial disease is a prevalent vascular condition leading to ischemic symptoms and increased risk of cardiovascular events. Drug-eluting stents have improved outcomes by reducing restenosis, with sirolimus emerging as a promising alternative to paclitaxel due to its safer profile. This study evaluates the efficacy and safety of novel polymer-free Amphilimus formulation (Sirolimus + fatty acid) eluting self-expanding stent in the treatment of femoropopliteal disease in a real-world population.
View Article and Find Full Text PDFJMIR Med Inform
September 2025
Department of Radiology, Air Force Medical Center, Air Force Medical University, Fucheng Road 30, Haidian District, Beijing, CN.
Background: Lateral malleolar avulsion fracture (LMAF) and subfibular ossicle (SFO) are distinct entities that both present as small bone fragments near the lateral malleolus on imaging, yet require different treatment strategies. Clinical and radiological differentiation is challenging, which can impede timely and precise management. On imaging, magnetic resonance imaging (MRI) is the diagnostic gold standard for differentiating LMAF from SFO, whereas radiological differentiation on computed tomography (CT) alone is challenging in routine practice.
View Article and Find Full Text PDFPurpose: The purpose of this document is to review current methods for cervical ripening and to summarize the effectiveness of these approaches based on appropriately conducted outcomes-based research. This document focuses on cervical ripening in individuals with term, singleton, vertex pregnancies with membranes intact, because this is the population in whom most studies were conducted. For more information on recommended timing of delivery based on maternal, fetal, and obstetric conditions and on labor management, refer to: American College of Obstetricians and Gynecologists (ACOG) Committee Opinion No.
View Article and Find Full Text PDFQual Life Res
September 2025
The Kids Research Institute Australia, The University of Western Australia, P.O. Box 855, West Perth, WA, 6872, Australia.
Purpose: CDKL5 deficiency disorder (CDD) is a rare developmental and epileptic encephalopathy. Greater understanding of the smallest meaningful improvements for individuals with CDD in clinical trials and practice is needed for a person-centred approach to treatment efficacy. This study explored how parent/caregivers of people with CDD understood meaningful improvements and described change for priority functional domains including communication, gross motor, fine motor, feeding.
View Article and Find Full Text PDF