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  • 文章类型: Journal Article
    心血管和癌症结果在心脏肿瘤生存护理领域相交,以种族差异为标志,种族,社会,和地理景观。尽管临床界越来越意识到这个复杂的问题,有效的解决方案正在落后。为了实现重大的公共卫生影响,癌症类型的检查和心血管风险缓解需要互补的方法来引出患者的观点,将其扩展到人口水平,并专注于可行的人群健康干预措施。采用这种多学科方法将加深我们对患者意识的理解,动机,健康素养,和社区资源,以解决心脏肿瘤学的独特挑战。地理空间分析有助于在粒度和更广泛的背景下确定需要的关键社区。在这次审查中,我们描绘了一条从个人到社区层面的障碍。从这些角度收集的数据对于告知干预措施至关重要,这些干预措施可以增强不同社区内的个人能力并改善心脏肿瘤的生存率。
    Cardiovascular and cancer outcomes intersect within the realm of cardio-oncology survivorship care, marked by disparities across ethnic, racial, social, and geographical landscapes. Although the clinical community is increasingly aware of this complex issue, effective solutions are trailing. To attain substantial public health impact, examinations of cancer types and cardiovascular risk mitigation require complementary approaches that elicit the patient\'s perspective, scale it to a population level, and focus on actionable population health interventions. Adopting such a multidisciplinary approach will deepen our understanding of patient awareness, motivation, health literacy, and community resources for addressing the unique challenges of cardio-oncology. Geospatial analysis aids in identifying key communities in need within both granular and broader contexts. In this review, we delineate a pathway that navigates barriers from individual to community levels. Data gleaned from these perspectives are critical in informing interventions that empower individuals within diverse communities and improve cardio-oncology survivorship.
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  • 文章类型: Journal Article
    结核病仍然是一个重大的全球卫生挑战。结核病影响全世界数百万人。结核病的早期发现在结核病的治疗管理中起着重要作用。本系统综述将分析几个已发表的关于早期发现结核病的研究结果。本系统综述强调了他们的方法和局限性,以及他们对我们理解这一紧迫问题的贡献。早期发现结核病可以通过结核病筛查接触者来实现。家庭接触者的全面健康教育可作为早期发现。内部深度学习模型可用于结核病自动检测的X射线。干扰素γ释放试验,常规被动和主动病例检测,便携式X射线和核酸扩增检测,和高度敏感的酶联免疫吸附试验在提高结核病检测中起着关键作用。
    Tuberculosis remains a significant global health challenge. Tuberculosis affects millions of individuals worldwide. Early detection of tuberculosis plays a relevant role in the management of treatment of tuberculosis. This systematic review will analyze the findings of several published studies on the topic of the early detection of tuberculosis. This systematic review highlights their methodologies and limitations as well as their contributions to our understanding of this pressing issue. Early detection of tuberculosis can be achieved through tuberculosis screening for contacts. Comprehensive health education for household contacts can be used as early detection. The in-house deep learning models can be used in the X-ray used for automatic detection of tuberculosis. Interferon gamma release assay, routine passive and active case detection, portable X-ray and nucleic acid amplification testing, and highly sensitive enzyme-linked immunosorbent assay tests play critical roles in improving tuberculosis detection.
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  • 文章类型: Journal Article
    背景:骨质疏松症是一个普遍关注的问题,特别是在老龄化人群中,导致骨折风险增加,包括与髋关节和膝关节置换术相关的手术。骨质疏松症筛查,尤其是双X射线吸收法(DXA)扫描,对于早期发现和管理至关重要。
    目的:本研究旨在评估65岁及以上在单一健康网络中接受选择性全髋关节置换术(THA)或全膝关节置换术(TKA)的患者对骨质疏松症筛查指南的依从性。还探讨了影响筛查依从性的因素。
    方法:对2019年1月至2023年1月期间接受选择性THA或TKA的2,160例患者进行了回顾性图表回顾。人口统计数据,骨质疏松症筛查状态,并对假体周围骨折的发生情况进行分析。统计分析包括描述性统计和卡方检验。
    结果:只有24.1%的合格患者在手术前接受了DXA扫描。女性比男性更有可能接受筛查,种族也与筛查状态相关.共发现45例假体周围骨折,骨质疏松状态之间没有显著的相关性,DXA筛查,和骨折的发生。
    结论:在所研究的健康网络中,接受选择性全关节置换术的老年患者对骨质疏松症筛查指南的依从性仍然很低。尽管在这项研究中,筛查和骨折发生之间缺乏相关性,强调高危患者筛查和潜在优化的重要性.需要进一步的研究来评估与选择性老年全关节患者骨健康筛查和管理中不同护理途径相关的结果。
    BACKGROUND: Osteoporosis is a prevalent concern, particularly among aging populations, leading to increased risk of fractures, including those related to hip and knee arthroplasty procedures. Screening for osteoporosis, especially with dual X-ray absorptiometry (DXA) scans, is crucial for early detection and management.
    OBJECTIVE: This study aimed to assess adherence to osteoporosis screening guidelines among patients aged 65 and older undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) within a single health network. Factors influencing screening adherence were also explored.
    METHODS: A retrospective chart review of 2,160 patients undergoing elective THA or TKA between January 2019 and January 2023 was conducted. Demographic data, osteoporosis screening status, and occurrence of periprosthetic fractures were analyzed. Statistical analysis included descriptive statistics and chi-square tests.
    RESULTS: Only 24.1 % of eligible patients underwent a DXA scan prior to surgery. Females were more likely to undergo screening than males, and race was also associated with screening status. A total of 45 periprosthetic fractures were identified, with no significant correlation between osteoporosis status, DXA screening, and fracture occurrence.
    CONCLUSIONS: Adherence to osteoporosis screening guidelines among geriatric patients undergoing elective total joint arthroplasty remains low within the studied health network. Despite the lack of correlation between screening and fracture occurrence in this study, the importance of screening and potential optimization in high-risk patients is emphasized. Further research is needed to assess outcomes associated with different care pathways in bone health screening and management for elective geriatric total joint patients.
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  • 文章类型: Journal Article
    物质使用与亲密伴侣暴力(IPV)密切相关,并且是IPV的可修改风险因素。然而,缺乏对同时发生的IPV和物质使用的全面筛查和转诊,以及他们的精神后遗症,限制了与物质相关的IPV的有效干预措施的识别和实施。这篇叙述性综述(1)调查了IPV筛查和转诊实践的文献,如果这些包括筛查物质使用或其他精神病合并症,(2)为当前的最佳实践提供建议,(3)提出了旨在识别和减少与物质相关的IPV的研究和实践的未来方向。
    一篇叙述性文献综述审查了在诊所中调查IPV筛查和转诊计划的研究。部分研究进行了回顾:(1)有效性,(2)实施和可持续性的障碍,和(3)对精神病共病的反应,包括物质使用和物质使用障碍(SUD)。
    研究结果表明,已经制定了有效的IPV筛查和转诊计划,但是IPV筛查存在差异,许多程序仅筛查IPV受害情况。IPV筛查计划的实施和可持续性的障碍包括缺乏持续的提供者培训,资金或机构支持,并直接连接到转介服务。Further,许多IPV筛查计划缺乏共患精神病的评估和转诊,包括物质使用,并且往往不在SUD诊所常规实施。
    需要开展额外的系统性工作,以制定与物质相关的IPV的普遍和全面的筛查和转诊计划,并解决长期可持续性问题。特别是在SUD治疗设置内。
    UNASSIGNED: Substance use is strongly associated with intimate partner violence (IPV) and is a modifiable risk factor for IPV. However, lack of comprehensive screening and referral for co-occurring IPV and substance use, along with their psychiatric sequalae, limits the identification and implementation of effective interventions for substance-related IPV. This narrative review (1) investigates the literature on screening and referral practices for IPV, and if these include screening for substance use or other psychiatric comorbidities, (2) provides recommendations for current best practices, and (3) suggests future directions for research and practice aimed at identifying and reducing substance-related IPV.
    UNASSIGNED: A narrative literature review examined studies investigating IPV screening and referral programs in clinics. Selected studies were reviewed for: (1) effectiveness, (2) barriers to implementation and sustainability, and (3) responsivity to psychiatric comorbidity, including substance use and substance use disorders (SUD).
    UNASSIGNED: Findings suggest that effective IPV screening and referral programs have been developed, but disparities in IPV screening exist and many programs only screen for IPV victimization. Barriers to the implementation and sustainability of IPV screening programs include lack of ongoing provider training, funding or institutional support, and direct connection to referral services. Further, many IPV screening programs lack assessment of and referral for comorbid psychiatric conditions, including substance use, and tend not to be routinely implemented in SUD clinics.
    UNASSIGNED: Additional systematic work is needed to develop universal and comprehensive screening and referral programs for substance-related IPV and address issues of long-term sustainability, particularly within SUD treatment settings.
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  • 文章类型: Journal Article
    背景:由于如今患者往往有多种疾病和复杂的病史,我们的目标是识别高质量的,非工具性吞咽困难筛查工具用于在急性护理环境中检测所有疾病类别的成人吞咽困难病例。
    方法:从每个数据库最早成立到2021年7月31日,在五个数据库中进行了文献检索,并以五个关键词为指导:“吞咽困难”,\'吞咽\',\'筛选\',\'test\'和\'measure\'。在不限制搜索任何特定疾病类别的情况下,审核员对原始研究进行了评估,并确定了工具是否经过了仪器评估的验证,以及是否将其设计为通过-失败程序来筛查吞咽困难是否不存在或存在.我们进一步排除了任何工具,如果它是(1)用于儿科焦点,或(2)患者自我报告问卷。使用经修订的诊断准确性研究质量评估工具(QUADAS-2)对所有最终候选工具进行了方法学质量评估。
    结果:在195项研究中,确定了165种工具,20名候选工具接受了QUADAS-2审查。我们发现了六个高质量的,在急性护理环境中检测成人吞咽困难病例的非工具筛查工具,包括耶鲁燕子协议,狼吞虎咽的屏幕,多伦多床边吞咽筛查测试(英语和葡萄牙语版本),Sapienza全球床边评估吞咽和两步加厚水测试。这些高质量的工具主要是为中风患者开发的。最初只有耶鲁燕子方案对中风的异质人群进行了测试,多发性硬化症,创伤性脑损伤,食道手术,神经外科和头颈癌.
    结论:结果突出表明,在包括老年住院患者在内的几个出现的高危人群中,缺乏高质量吞咽困难筛查工具的差距,或气管内拔管后的患者。需要进一步的研究来确定这六种工具是否可以有效地应用于急性护理环境中的不同高危人群,以筛选病例发现。
    BACKGROUND: As patients nowadays tend to have multiple diseases and complex medical histories, our aim was to identify high-quality, non-instrumental dysphagia screening tools used for the detection of adult dysphagia cases in all disease categories in acute-care settings.
    METHODS: A literature search was conducted in five databases from each database\'s earliest inception to 31 July 2021 and guided by five keywords: \'dysphagia\', \'deglutition\', \'screening\', \'test\' and \'measure\'. Without limiting the search in any specific disease category, reviewers assessed original studies and identified tools if they had been validated against instrumental evaluations and if they had been designed as a pass-fail procedure to screen whether dysphagia is absent or present. We further excluded any tool if it was (1) for pediatric focus, or (2) a patient self-report questionnaire. All final tool candidates underwent a methodological quality appraisal using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2).
    RESULTS: Out of 195 studies with 165 tools identified, 20 tool candidates underwent QUADAS-2 review. We found six high-quality, non-instrumental screening tools for detecting adult dysphagia cases in acute-care settings, including the Yale Swallow Protocol, Gugging Swallowing Screen, Toronto Bedside Swallowing Screening Test (both English and Portuguese versions), Sapienza Global Bedside Evaluation of Swallowing and Two-Step Thickened Water Test. These high-quality tools were developed primarily for patients with stroke. Only Yale Swallow Protocol was originally tested for heterogeneous populations with stroke, multiple sclerosis, traumatic brain injury, oesophageal surgery, neurosurgery and head-and-neck cancer.
    CONCLUSIONS: The results highlight the gap in the unavailability of high-quality dysphagia screening tool in several emerged high-risk populations including elderly inpatients, or patients following endotracheal extubation. Further research is needed to determine whether these six tools can be effectively applied across different high-risk populations in acute-care settings to screen for cases finding.
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  • 文章类型: Journal Article
    主动脉缩窄(CoA)与颅内动脉瘤(IAs)有关;然而,患病率和危险因素(RFs)没有很好的描述。当前的实践指南对该患者人群中的IAs筛查提供了不一致的建议,范围从“不推荐”(欧洲心脏病学会2020年)到“推荐”(美国心脏协会2018年)。
    这项研究的目的是确定CoA患者中IAs的患病率和RF。
    我们利用计算机断层扫描或磁共振血管造影筛查CoA患者的IAs,对研究进行了系统评价和荟萃分析。
    纳入了五项队列研究,代表442名患者。CoA患者中IAs的合并患病率为3.8%[95%CI:0.1%-12.3%]。结果符合我们对高异质性的预定定义。在评估的5个RF中,只有高血压与IAs的发展相关,比值比为3.1[95%CI:1.1-8.2;P=0.03].在纳入的研究中,随着时间的推移,IAs的患病率呈下降趋势。
    IAs的发展在病因上可能是多因素的,并且在其发展中可能存在可修改的RF。考虑到IAs在汇总结果中的患病率较低,对CoA患者进行IAs常规筛查的价值可能较低。
    UNASSIGNED: Coarctation of the aorta (CoA) is associated with intracranial aneurysms (IAs); however, the prevalence and risk factors (RFs) are not well described. Current practice guidelines offer inconsistent recommendations on screening for IAs in this patient population ranging from \"not recommended\" (European Society of Cardiology 2020) to \"recommended\" (American Heart Association 2018).
    UNASSIGNED: The purpose of this study was to determine the prevalence and RFs for IAs in patients with CoA.
    UNASSIGNED: We completed a systematic review and meta-analysis of studies utilizing computed tomography or magnetic resonance angiographic screening for IAs in patients with CoA.
    UNASSIGNED: Five cohort studies were included, representing 442 patients. The pooled prevalence of IAs in patients with CoA was 3.8% [95% CI: 0.1%-12.3%]. The results met our prespecified definition for high heterogeneity. Of 5 RFs evaluated, only hypertension was associated with the development of IAs with an odds ratio of 3.1 [95% CI: 1.1-8.2; P = 0.03]. There was an observed downward trend over time in the prevalence of IAs among the studies included.
    UNASSIGNED: The development of IAs is likely multifactorial in etiology and there may be modifiable RFs in their development. Considering the low prevalence of IAs in the pooled result, routine screening of patients with CoA for IAs is likely of low-value.
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  • 文章类型: Journal Article
    乳腺癌是全球女性人群中最常见的恶性肿瘤,也是围绝经期妇女死亡的主要原因。筛查是必不可少的,因为早期检测结合乳腺癌治疗的改善可以降低相关死亡率。这项研究的目的是回顾和比较已发表的乳腺癌筛查指南的建议。2014年至2022年间发布的总共14份乳腺癌筛查指南被确定。世界卫生组织(WHO)对相关指南的描述性审查,美国预防服务工作组(USPSTF),美国癌症协会(ACS)国家综合癌症网络(NCCN)美国妇产科学院(ACOG),美国乳腺外科医师协会(ASBrS),美国放射学院(ACR),预防保健工作组(CTFPHC),欧盟委员会乳腺癌倡议(ECIBC),欧洲医学肿瘤学会(ESMO),澳大利亚皇家全科医师学院(RACGP)和日本临床肿瘤学杂志(JJCO)对普通和高危女性进行了研究.在所有审查的指南中,有一个共识,即乳房X线照相术是平均风险女性的黄金标准筛查方式。对于这个风险群体来说,大多数指南建议在40-74岁时进行年度或两年一次的乳房X光检查,而筛查应特别集中在50-69岁。大多数指南建议停止筛查的年龄限制应根据女性的健康状况和预期寿命来确定。对于高危女性来说,大多数指南建议使用年度乳房X线照相术或磁共振成像,虽然起始年龄应该比平均风险组早,取决于风险因素。关于各种高风险类别的筛查开始年龄的建议之间存在差异。为最合适的乳腺癌筛查计划制定一致的国际惯例方案似乎对降低死亡率和安全指导日常临床实践至关重要。
    Breast cancer is the most common malignancy diagnosed in the female population worldwide and the leading cause of death among perimenopausal women. Screening is essential, since earlier detection in combination with improvements in breast cancer treatment can reduce the associated mortality. The aim of this study was to review and compare the recommendations from published guidelines on breast cancer screening. A total of 14 guidelines on breast cancer screening issued between 2014 and 2022 were identified. A descriptive review of relevant guidelines by the World Health Organization (WHO), the U.S. Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), the National Comprehensive Cancer Network (NCCN), the American College of Obstetricians and Gynecologists (ACOG), the American Society of Breast Surgeons (ASBrS), the American College of Radiology (ACR), the Task Force on Preventive Health Care (CTFPHC), the European Commission Initiative on Breast Cancer (ECIBC), the European Society for Medical Oncology (ESMO), the Royal Australian College of General Practitioners (RACGP) and the Japanese Journal of Clinical Oncology (JJCO) for women both at average and high-risk was carried out. There is a consensus among all the reviewed guidelines that mammography is the gold standard screening modality for average-risk women. For this risk group, most of the guidelines suggest annual or biennial mammographic screening at 40-74 years, while screening should particularly focus at 50-69 years. Most of the guidelines suggest that the age limit to stop screening should be determined based on the women\'s health status and life expectancy. For women at high-risk, most guidelines recommend the use of annual mammography or magnetic resonance imaging, while the starting age should be earlier than the average-risk group, depending on the risk factor. There is discrepancy among the recommendations regarding the age at onset of screening in the various high-risk categories. The development of consistent international practice protocols for the most appropriate breast cancer screening programs seems of major importance to reduce mortality rates and safely guide everyday clinical practice.
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  • 文章类型: Journal Article
    有效和可靠的发育筛查和评估工具使专业人员能够识别儿童的残疾/延误,能够及时干预,以限制对健康的不利影响。然而,儿童发展的差异与文化有关,遗传学,围产期结局可能会影响工具的适用性。本研究评估了效度,可靠性,以及幼儿多领域发展筛查工具的可及性,分析了工具在不同环境下的适用性,并创建了一个工具简编。采用适应的现实主义审查方法,我们搜索了APAPsycInfo,MEDLINE,CINAHL,ERIC,和谷歌来识别相关的文章和信息。我们评估了可达性,有效性,可靠性,和上下文适用性(N=4110证据来源),以创建工具评级并提出建议。在33个确定的工具中,22个是筛查,11个是评估工具。总体评价较高的筛选工具比评估工具少。这两种工具通常都缺乏在不同文化中使用的证据。ASQ(筛选)和BDI(评估)工具被评为最有利的,建议使用,尽管其他工具可能更适用于不同的环境(例如,患有阿斯伯格综合症的儿童中的NEPSY)。未来的研究应侧重于评估不同人口统计学工具的有效性和可靠性,以增加可访问性,并确保所有儿童都得到适当的支持。
    Valid and reliable developmental screening and assessment tools allow professionals to identify disabilities/delays in children, enabling timely intervention to limit adverse lifelong impacts on health. However, differences in child development related to culture, genetics, and perinatal outcomes may impact tool applicability. This study evaluated the validity, reliability, and accessibility of multidomain developmental screening tools for young children, analyzed the applicability of tools across different contexts, and created a compendium of tools. Employing adapted realist review methods, we searched APA PsycInfo, MEDLINE, CINAHL, ERIC, and Google to identify relevant articles and information. We assessed accessibility, validity, reliability, and contextual applicability (N = 4110 evidence sources) to create tool ratings and make recommendations. Of 33 identified tools, 22 were screening and 11 were assessment tools. Fewer screening tools than assessment tools were rated highly overall. Evidence for use in different cultures was often lacking for both types of tools. The ASQ (screening) and BDI (assessment) tools were rated most favorably and are recommended for use, though other tools may be more applicable in different contexts (e.g., NEPSY among children with Asperger\'s Syndrome). Future research should focus on assessing the validity and reliability of tools across different demographics to increase accessibility and ensure all children are properly supported.
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  • 文章类型: Journal Article
    胰腺导管腺癌(PDAC)仍然是肿瘤学中最严峻的挑战之一。其特点是发现晚、预后差。人工智能(AI)和机器学习(ML)正在成为在各个方面彻底改变PDAC护理的关键工具。因此,许多研究都集中在使用人工智能来提高PDAC护理的标准。这篇综述文章试图巩固过去五年的文献,以确定高影响力,小说,以及有意义的研究,重点是它们在PDAC管理中的变革潜力。我们的分析涵盖了广泛的应用,包括但不限于患者风险分层,早期发现,和治疗结果的预测,从而突出AI在提高PDAC护理质量和精度方面的潜在作用。通过将文献分类为反映患者从筛查和诊断到治疗和生存的旅程的离散部分,本综述对AI驱动的方法在解决PDAC的多方面挑战方面进行了全面的研究.每一项研究都是通过解释数据集来总结的,ML模型,评估指标,以及该研究对改善PDAC相关结局的影响。我们还讨论了PDAC背景下人工智能应用中固有的主要障碍和限制,对潜在的未来方向和创新提供有见地的观点。
    Pancreatic Ductal Adenocarcinoma (PDAC) remains one of the most formidable challenges in oncology, characterized by its late detection and poor prognosis. Artificial intelligence (AI) and machine learning (ML) are emerging as pivotal tools in revolutionizing PDAC care across various dimensions. Consequently, many studies have focused on using AI to improve the standard of PDAC care. This review article attempts to consolidate the literature from the past five years to identify high-impact, novel, and meaningful studies focusing on their transformative potential in PDAC management. Our analysis spans a broad spectrum of applications, including but not limited to patient risk stratification, early detection, and prediction of treatment outcomes, thereby highlighting AI\'s potential role in enhancing the quality and precision of PDAC care. By categorizing the literature into discrete sections reflective of a patient\'s journey from screening and diagnosis through treatment and survivorship, this review offers a comprehensive examination of AI-driven methodologies in addressing the multifaceted challenges of PDAC. Each study is summarized by explaining the dataset, ML model, evaluation metrics, and impact the study has on improving PDAC-related outcomes. We also discuss prevailing obstacles and limitations inherent in the application of AI within the PDAC context, offering insightful perspectives on potential future directions and innovations.
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  • 文章类型: Journal Article
    幽门螺杆菌(H.pylori),一种病原体,在过去的十年里,全球范围内都在下降。迄今为止,幽门螺杆菌的管理集中在反应性方法上,其中那些诊断与抗微生物剂和酸抑制的组合治疗。这篇综述文章概述了幽门螺杆菌的管理从反应性方法向主动“筛选和治疗”方法的转变;本文通过探索相似性,如大多数国家四联疗法的一线处方,反映了目前幽门螺杆菌治疗的药理学景观,并提供了欧洲最佳实践指导的汇总表。亚洲,和北美。它探讨了管理中持续存在的重大挑战,例如抗菌素耐药率上升,并探索了一种潜在的“智能工作”方法来进行抗菌药物敏感性测试。我们探讨了注册数据库在提供治疗有效性和安全性数据方面的作用,以及它们如何支持幽门螺杆菌治疗的战略方法。我们质疑这样一个数据库的可用性,更新,定期审计应作为人口筛查计划的关键质量指标。尽管呼吁针对幽门螺杆菌的疫苗接种和数十年的研究,没有多少人进入第三阶段临床试验。我们探索了使这种疫苗开发复杂化的挑战,比如幽门螺杆菌的遗传多样性,免疫耐受,以及研究中小鼠模型的局限性;我们反思了这些挑战如何导致在中短期内接种疫苗的可能性较低。最后,它探讨了益生菌研究的异质性及其在幽门螺杆菌管理中的辅助作用。
    The prevalence of Helicobacter pylori (H. pylori), a pathogen, has decreased globally in the last decade. To date, the management of H. pylori has focused on a reactive approach, whereby those diagnosed are treated with antimicrobials and acid suppression in combination. This review article provides an overview of the shift in the management of H. pylori from a reactive approach towards a proactive \'screen and treat\' approach; the article reflects the current pharmacological landscape for H. pylori treatment by exploring similarities such as the first-line prescription of quadruple therapy in most countries and provides a summary table of the best practice guidance from Europe, Asia, and North America. It explores significant ongoing challenges in management, such as rising antimicrobial resistance rates, and explores a potential \'work smart\' approach to antimicrobial susceptibility testing. We explore the role of registry databases in providing data on treatment efficacy and safety and how they can support a strategic approach to H. pylori treatment. We question if such a database\'s availability, update, and regular audit should serve as a key quality indicator in a population screening programme. Despite a call for vaccination against H. pylori and decades of research, not many have made it to a phase-three clinical trial. We explore the challenges that have complicated the development of such a vaccine, such as the genetic diversity of H. pylori, immunotolerance, and limitations of mouse models in research; we reflect on how these challenges are contributing to a low likelihood of having a vaccine in the short-medium term. Lastly, it explores the heterogeneity in research on probiotics and their role as an adjunct in the management of H. pylori.
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