Towards optimal use of antithrombotic therapy of people with cancer at the end of life: A research protocol for the development and implementation of the SERENITY shared decision support tool

Anticoagulants; Hemorrhage; ThrombosisAnticoagulantes; Hemorragia; TrombosisAnticoagulants; Hemorràgia; TrombosiBackground Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs. Methods The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe. Results SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life. Conclusions We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers

AMS-800 Artificial urinary sphincter in female patients with stress urinary incontinence: a systematic review

Aims: To perform a systematic review of studies reporting the outcomes of AMS-800 artificial urinary sphincter (AUS) implantation in female patients with stress urinary incontinence (SUI) resulting from intrinsic sphincter deficiency (ISD). Methods: A systematic literature search of the Medline and Embase databases was performed in June 2018 in accordance with the PRISMA statement. No time limit was used. The protocol was registered in PROSPERO (CRD42018099612). Study selection and data extraction were performed by two independent reviewers. Results: Of 886 records screened, 17 were included. All were retrospective or prospective non-comparative case series. One study reported on vaginal AUS implantation, 11 on open AUS implantation, two on laparoscopic AUS implantation, two on robot-assisted AUS implantation and one compared open and robot-assisted implantations. The vast majority of patients had undergone at least one anti-incontinence surgical procedure prior to AUS implantation (69.1-100%). The intraoperative bladder neck injury rates ranged from 0% to 43.8% and the intraoperative vaginal injury rates ranged from 0 to 25%. After mean follow-up periods ranging from 5 to 204 months, the complete continence rates ranged from 61.1% to 100%. The rates of explantation, erosion and mechanical failure varied from 0% to 45.3%, 0% to 22.2% and 0% to 44.1%, respectively. Conclusions: AMS-800 AUS can provide excellent functional outcomes in female patients with SUI resulting from ISD but at the cost of a relatively high morbidity. High level of evidence studies are needed to help better define the role of AUS in the female SUI armamentarium

Allende vive 30 años

El Seminario Internacional 30 Años Allende Vive, convocado por la Revista América Libre, el Centro de Educación Popular, CEPIS, de Brasil, el Centro Martín Luther King de Cuba y el ICAL, en un momento en que las luchas populares retoman la iniciativa, se planteó rescatar la memoria del proceso de la Unidad Popular y del ejemplo de Salvador Allende y proyectarla a las búsquedas que los movimientos populares realizan para construir alternativas al neoliberalismo, la emergencia de nuevos gobiernos populares, los caminos de creación de poder popular, la perspectiva socialista como proyecto y como opción. La publicación del seminario 30 Años Allende Vive constituye un aporte para la reflexión de la izquierda latinoamericana, y una importante fuente de consulta tanto para referencias históricas como para los muy actuales debates sobre la construcción de alternativas de cambio con perspectiva socialista.Presentación; Discurso de Inauguración del Seminario Internacional 30 Años, Allende Vive; Inauguración del Seminario 30 Años, Allende Vive; Saludos; Transformaciones de Estructura y Redistribución del Ingreso; La educación y la cultura en el Gobierno Popular; Reforma Agraria y Soberanía Alimentaria; Los logros de la Unidad Popular y las perspectivas en diferentes sectores sociales; Soberanía sobre los Recursos Naturales. El Cobre; El programa de gobierno de Salvador Allende; La Verdad sobre la Unidad Popular y el Golpe de Estado; Unidad Popular, Impacto y Solidaridad Internacional; Presentación del libro Salvador Allende, Textos Escogidos; La política imperialista. El ALCA y la militarización del mundo. El Plan Colombia; La unidad de los pueblos contra la estrategia imperialista, guerrerista, desestabilizadora y golpista de Estados Unidos; Ponencia de las Fuerzas Armadas Revolucionarias de Colombia Ejército del Pueblo (FARC-EP); Los cristianos en la lucha por el socialismo; Fuerzas Armadas, Democracia y Soberanía Nacional; Situación del movimiento sindical antes y después del golpe; Derechos Humanos antes y después del golpe de estado; Movimientos GLBTT y Procesos Revolucionarios en América Latina. Construyendo el nuevo sujeto histórico; Políticas de Género de la Izquierda Latinoamericana; Panel sobre Medios de comunicación; Gobernar la revolución. Por una gobernabilidad revolucionaria para la revolución bolivariana; La integración latinoamericana y el sueño bolivariano; Las alternativas populares en América Latina ayer y hoy. Izquierda e Institucionalidad, Reforma y Revolución; Los movimientos sociales y los partidos políticos en la construcción de las alternativas populares. Sujeto histórico, alianzas, programas, estrategias; La perspectiva socialista en la construcción de las alternativas populare