University of Medicine and Pharmacy of Ho Chi Minh City

Background The burden of gastric cancer remains substantial in Asia. Gastric premalignant conditions, including chronic atrophic gastritis, intestinal metaplasia and dysplasia, are important intermediate stages in the gastric carcinogenesis cascade. The sojourn time allows endoscopic surveillance to have a pivotal role in early detection and timely intervention.Objective This task force was commissioned by the Asian Pacific Association of Gastroenterology to formulate recommendations for the surveillance and management of Helicobacter pylori associated gastric premalignant conditions in the region.Design A systematic literature review was conducted across multiple databases, including PubMed, Cochrane Library and Embase, focusing on studies related to gastric premalignant conditions and their surveillance, particularly from Asia. The evidence quality and strength of recommendations were appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.Results These recommendations address four key aspects of gastric premalignant condition surveillance: (1) epidemiology and risk factors; (2) endoscopic and histopathological diagnosis; (3) risk stratification and endoscopic surveillance strategies; and (4) management strategies. 28 statements were made after multiple rounds of voting by experts. The statements offer a comprehensive, evidence based framework designed to assist clinicians in the Asia Pacific region on the early detection and management of gastric premalignant conditions.Conclusion These statements aim to provide a structured, evidence based surveillance framework for clinical practice in the Asia Pacific region, while also identifying priority areas for future research.

Cancer remains a global health challenge, with conventional treatments limited by toxicity and drug resistance. Propolis, a natural resin with promising anticancer properties but restricted in clinical applications due to low bioavailability and poor solubility. Nanotechnology, offers a potential approach to enhance propolis’ therapeutic efficacy through more efficient delivery and improved pharmacokinetics. Propolis-loaded niosomes (PLNs) were prepared using the ethanol injection method, optimized using response surface methodology (RSM) for surfactant type (Tween 80), cholesterol-to-surfactant ratio, and propolis content. Physicochemical properties, including particle size, polydispersity index (PDI), and zeta potential were characterized. Stability was assessed under various storage conditions, and total polyphenol content (TPC) and entrapment efficiency (EE%) were determined. Anticancer activity was in vitro assessed against MCF7 breast cancer and L929 fibroblast cell lines. The optimized PLN formulation (at a mass ratio 4:1:8 of propolis: cholesterol: Tween 80, respectively) achieved a particle size of 193.5 nm, PDI of 0.123, and zeta potential of −19.6 mV, with a TPC of 21.83 mg GAE g −1 and EE% of 57.82%. Stability studies confirmed optimized formulation’s robustness at 4 °C, with minimal changes over 42 d, though higher temperatures induced aggregation. PLNs exhibited superior cytotoxicity against MCF7 cells inhibitory concentration (IC 50 equivalent to 106.85 µg ml −1 ) compared to L929 cells (IC 50 equivalent to 127.14 µg ml −1 ). The formulation’s uniformity and moderate stability support its potential for targeted drug delivery. PLNs effectively enhance propolis’ anticancer efficacy and bioavailability, offering a promising delivery system for cancer therapy. Future studies should focus on improving zeta potential, in vivo validation, and encapsulation efficiency to advance clinical translation.

INTRODUCTION:While outcomes of simultaneous penile prosthesis (PP) and artificial urinary sphincter (AUS) implantation are well documented, comparative data on single-incision versus dual-incision techniques remain limited. OBJECTIVES:This narrative review aims to synthesize the available evidence comparing clinical outcomes and complication rates between these two surgical approaches in patients undergoing simultaneous dual implantation. METHODS:A structured literature review of MEDLINE (OVID), PubMed, and the Cochrane Library was performed from database inception through October 2024 to identify studies reporting outcomes and complications following simultaneous PP and AUS implantation. Patients were grouped according to surgical approach: single incision (penoscrotal or perineal) versus dual incision. The reported outcomes included device infection, revision rates, urethral erosion, and mechanical failure. Quantitative outcome ranges and pooled proportions were summarized descriptively. RESULTS:Ten studies comprising 269 patients were included. Of these, 167 underwent dual implantation via a single incision, and 102 via dual incisions. The mean age ranged from 58 to 68 years across cohorts, with a median follow-up ranging from 12 to 72 months. Social continence (defined as ≤1 pad per day) in the single-incision group ranged from 72% to 96%, compared with approximately 90% in the dual-incision group. Functional penile prosthesis rates were consistently above 96% in both groups. The single-incision group demonstrated lower reported rates of revision (16.5% vs 30.5%) and mechanical failure (2.8% vs 13.1%) compared with the dual-incision group; however, outcome ranges overlapped substantially across studies. Rates of device infection (4.1% vs 5.1%) and urethral erosion (10.0% vs 7.0%) were similar between surgical approaches. CONCLUSIONS:Simultaneous PP and AUS implantation via a single incision demonstrates clinical outcomes comparable to the dual-incision technique, with similar rates of infection, urethral erosion, mechanical failure, and revisions. These findings support the feasibility of either approach for simultaneous implantation.

Streptococcus agalactiae, commonly referred to as Group B Streptococcus (GBS), was the most common neonatal infection. Antenatal GBS screening is recommended to reduce the risk of GBS transmission from mother to newborn. GBS is diagnosed using traditional culture methods and qPCR; however, in some cases, these methods cannot be applied for diagnosis. Therefore, we studied the potential application of polymerase spiral reaction (PSR) in direct GBS diagnosis from rectovaginal swab samples from 35 to 37 week pregnant women. Results showed that PSR reactions can be performed at 62°C for 50 minutes, with a detection limit down to 25 bacteria/reaction. For clinical samples, our design could detect GBS with sensitivity, specificity, diagnostic accuracy and a Kappa index of 84%, 90%, 87% and 0.74, 88%, 83%, 85% and 0.68 when compared to qPCR and microbiological culture methods respectively. The study needs to be expanded to improve the sensitivity and accuracy of the reaction, but it shows potential for application in GBS diagnosis in pregnant women.

OBJECTIVE:Body mass index (BMI), glomerular filtration rate (GFR), and pretreatment urate levels have been reported to influence the urate-lowering response to allopurinol. We investigated whether the fractional excretion of uric acid (FEUA) also modulates this response and relates to oxypurinol concentrations. We further evaluated its potential influence on febuxostat, not as a direct comparison, but to determine whether the effect of FEUA was specific to allopurinol. METHODS:The data are from n = 1,547 and n = 296 patients starting allopurinol and febuxostat, respectively. The relationship between FEUA (≤5.5% or >5.5%) and the dose response to allopurinol or febuxostat was assessed by linear mixed-effects regression models on serum urate levels and adjusted for BMI, estimated GFR (eGFR), and treatment doses. Concentrations of oxypurinol were measured in a subgroup of patients (n = 181). A multiple linear regression model was used to assess the association between FEUA and oxypurinol concentrations, adjusted for BMI, eGFR, allopurinol dosage, and serum urate levels. RESULTS:The median FEUA in the whole population was 4.0% (quartile 1-3: 3%-5.1%). The changes in serum urate levels for each 150-mg increase in allopurinol in patients with FEUA ≤5.5% or >5.5% were -72.37 (confidence interval [CI] -74.81 to -69.94) μM and -65.96 (CI -71.29 to -60.62) μM, respectively (P = 0.032). We found higher oxypurinol concentrations in patients with the lowest FEUA (P = 0.032). However, we did not observe any interaction between the febuxostat response and FEUA (P = 0.13). CONCLUSION:Allopurinol is more effective in patients with low FEUA, probably because of the reduced renal excretion of oxypurinol. These data highlight the similarity between the renal handling of oxypurinol and urate.