Targeting Capillary Refill Time in Early Septic Shock Reduced Duration of Organ Support: Key Findings from ANDROMEDA‑SHOCK‑2
Posted inCritical Care news

Targeting Capillary Refill Time in Early Septic Shock Reduced Duration of Organ Support: Key Findings from ANDROMEDA‑SHOCK‑2

ANDROMEDA‑SHOCK‑2 randomized 1,501 patients with early septic shock to a personalized CRT‑guided hemodynamic protocol versus usual care. A hierarchical composite outcome favored the CRT strategy (win ratio 1.16; 95% CI 1.02–1.33; P = .04), driven mainly by shorter duration of organ support rather than lower mortality.
Endoscopic Ultrasound–Guided Gastroenterostomy Outperforms Surgical Gastrojejunostomy for Malignant Gastric Outlet Obstruction: randomized trial shows faster recovery, shorter stay and lower costs
Posted inGastroenterology General Surgery news

Endoscopic Ultrasound–Guided Gastroenterostomy Outperforms Surgical Gastrojejunostomy for Malignant Gastric Outlet Obstruction: randomized trial shows faster recovery, shorter stay and lower costs

A multicentre randomized trial found EUS-guided gastroenterostomy (EUS-GE) superior to surgical gastrojejunostomy (SGJ) for malignant gastric outlet obstruction—improving oral intake, shortening hospital stay, enhancing quality of life and reducing costs.
ENDURO trial: EUS‑guided gastroenterostomy shortens time to oral intake and matches surgery for palliation of malignant gastric outlet obstruction
Posted inGastroenterology news Oncology

ENDURO trial: EUS‑guided gastroenterostomy shortens time to oral intake and matches surgery for palliation of malignant gastric outlet obstruction

A randomized trial (ENDURO) found endoscopic ultrasound‑guided gastroenterostomy (EUS‑GE) enabled earlier resumption of solid food and was non‑inferior to surgical gastrojejunostomy for recurrent obstruction, supporting EUS‑GE as preferred palliative therapy when expertise is available.
EUS-Guided Gastroenterostomy Beats Surgical Gastrojejunostomy for Malignant Gastric Outlet Obstruction: Randomised Trial Shows Faster Diet, Shorter Stay and Lower Costs
Posted inGastroenterology General Surgery news

EUS-Guided Gastroenterostomy Beats Surgical Gastrojejunostomy for Malignant Gastric Outlet Obstruction: Randomised Trial Shows Faster Diet, Shorter Stay and Lower Costs

A multicentre randomized trial (NCT05548114) found endoscopic ultrasound‑guided gastroenterostomy (EUS‑GE) superior to surgical gastrojejunostomy (SGJ) for malignant gastric outlet obstruction, with faster return to solid diet, shorter hospitalisation, better quality-of-life and lower costs.
CTNNA1 Truncating Variants Define a Moderate-Penetrance Hereditary Diffuse Gastric Cancer Spectrum — Implications for Testing, Surveillance and Risk Reduction
Posted inGastroenterology news Oncology

CTNNA1 Truncating Variants Define a Moderate-Penetrance Hereditary Diffuse Gastric Cancer Spectrum — Implications for Testing, Surveillance and Risk Reduction

Large clinical and functional study shows CTNNA1-truncating variants cause loss of αE-catenin via nonsense-mediated decay, confer substantially elevated risks of diffuse gastric cancer and lobular breast cancer versus general population but are less penetrant than CDH1 mutations; proposes simplified testing ('Porto' criteria) and clinical implications.
A 250‑ml Ultrafiltration Challenge Identifies Patients at Risk of Becoming Preload‑Dependent During CRRT
Posted inCritical Care Nephrology news

A 250‑ml Ultrafiltration Challenge Identifies Patients at Risk of Becoming Preload‑Dependent During CRRT

A randomized cross‑over trial found that a 250‑ml net ultrafiltration challenge reliably identified preload‑independent critically ill patients who became preload‑dependent during continuous renal replacement therapy; a ≥5% calibrated cardiac index change during a postural maneuver predicted this risk.
Resistance Training in the ICU Improves Muscle, Function, and Survival — HMB Adds Only Modest Benefit
Posted inCritical Care news Rehabilitation Medicine

Resistance Training in the ICU Improves Muscle, Function, and Survival — HMB Adds Only Modest Benefit

A multicenter 2×2 factorial RCT in 266 critically ill adults shows that in‑ICU resistance training improves discharge physical function, muscle mass, patient‑reported outcomes, and lowers 6‑ and 12‑month mortality; HMB supplementation produced only small gains in phase angle and fatigue with no additive effect.
Nationwide Prevention Programme in Australia Associated with Lower Preterm and Early‑Term Singleton Births: National and Hospital‑Level Results
Posted innews OB/GYN & Women's Health Public Health

Nationwide Prevention Programme in Australia Associated with Lower Preterm and Early‑Term Singleton Births: National and Hospital‑Level Results

A multifaceted national preterm birth prevention programme in Australia was associated with a modest national decrease in late preterm births and, after a hospital collaborative, a substantial reduction in early‑term births in participating centres, without increasing preterm rates.
Multi‑armoured oncolytic HSV‑1 (VG161) shows immune remodelling and promising activity in advanced intrahepatic cholangiocarcinoma: pooled early‑phase insights
Posted innews Oncology

Multi‑armoured oncolytic HSV‑1 (VG161) shows immune remodelling and promising activity in advanced intrahepatic cholangiocarcinoma: pooled early‑phase insights

Pooled Phase I/IIa data (n=24) indicate intratumoural VG161 is well tolerated in advanced intrahepatic cholangiocarcinoma, elicits local and systemic immune activation (APC recruitment, CD8+ T‑cell activation, M2 macrophage depletion) and suggests clinical benefit — including signals versus historical second‑line FOLFOX — warranting randomized validation.
Location Alone Shouldn’t Drive ESD: French Registry Finds Similar Submucosal Cancer Rates in Large Rectal and Colonic Non‑Pedunculated Polyps
Posted inGastroenterology news

Location Alone Shouldn’t Drive ESD: French Registry Finds Similar Submucosal Cancer Rates in Large Rectal and Colonic Non‑Pedunculated Polyps

A multicentre French ESD registry found that, after adjusting for size and morphology, large non‑pedunculated rectal polyps do not have higher rates of submucosal invasive cancer than equivalent colonic lesions; technical outcomes of ESD were comparable, with a trend to higher complications in the colon.