geoffrey modest medical blogs

  the American College of Gastroenterology (ACG) just published their new H Pylori treatment guidelines (see   H pylori treatment JAMA2026  in dropbox, or doi:10.1001/jama.2026.0663) Details : -- the American College of Gastroenterology updated their previous guideline suggestions on H Pylori treatment based on the increasing resistance of H Pylori bacteria to the prior meds -- these recommendations apply to patients at least 18yo who reside in North America     -- the guidelines prioritized studies done in the US that assessed both treatment-naive and treatment-experienced patients -- their concern is that H pylori is associated with the development of gastritis, peptic ulcers, and gastric cancer -- they incorporated the use of rifabutin and the more potent gastric acid suppressant vonoprazan     -- of the overall 11 recommendations, 5 were for treatment-naive patients (1 strong recommendation based on moderate quality of evidence (QOE)   ...

  A recent meta-analysis confirmed that gout needs to be treated with anti-inflammatory meds for longer than three months   after initiating urate-lowering meds  in order to decrease the risk of a recurrent flare  (see   gout flares high after stopping prophy ArthCareRes2024  in dropbox, or DOI 10.1002/acr.25486)   Details: --researchers found 6 trials in the literature and one with aggregated unpublished data from the VA (the VA STOP Gout trial), with a total of 2972 participants     -- these trials were chosen because they had at least one study arm with starting or intensifying urate-lowering therapy (ULT) in which anti-inflammatory prophylaxis was prescribed; these included trials needed to report the percentage of participants with at least one gout flare both during and after the period of anti-inflammatory prophylaxis was  documented  -- trial durations ranged from 24 to 104 weeks, and anti-inflammatory prophylaxis durations ...