Therapy Areas

Bariatric surgery's decline: Is it more than GLP-1s?

Bariatric surgery rates saw a decline before the COVID-19 pandemic, a trend that predates the widespread adoption of GLP-1 receptor agonists for weight management.

Lung cancer in never smokers: The 60x risk factor you might be missing

A specific EGFR variant significantly increases lung cancer risk in individuals who have never smoked, challenging traditional views on lung cancer etiology. This genetic predisposition highlights a critical, often overlooked, pathway to disease development.

GLP-1s: Why higher BMI doesn't protect bones in diabetes

GLP-1 receptor agonists may reduce fracture risk in patients with type 2 diabetes and obesity, a population often vulnerable to bone fragility despite higher body mass.

GLP-1 'super responders' aren't who you think they are

GLP-1 receptor agonists have transformed obesity and type 2 diabetes management, but patient responses vary significantly. Identifying 'super responders' could optimize treatment strategies and resource allocation.

ACLF: Why G-CSF works for some, but fails others

Specific immune cell populations and inflammatory markers predict G-CSF treatment response and mortality in acute-on-chronic liver failure, a GRAFT sub-study shows.

Rethinking xylitol: Is this 'healthy' sugar substitute a cardiac threat?

Xylitol, a common sugar alcohol, has been linked to an elevated risk for major adverse cardiovascular events, raising concerns about its widespread use.

Hypertension: Do shorter wall squats work as well for older women?

Isometric wall squats reduced blood pressure in older women with hypertension, but a higher dose did not offer superior postexercise hypotension.

Alzheimer's blood tests: Why are unverified claims spreading so fast?

Unverified claims about a new Alzheimer's blood test are circulating online, creating confusion for patients and clinicians alike. These claims often overstate the test's diagnostic capabilities and clinical utility.

Hyperactivity and ID: It's not just genetics, it's O-GlcNAc dyshomeostasis

Pathogenic O-GlcNAc dyshomeostasis, driven by OGT gene variants, causes cortical malformations and hyperactivity in a rodent model, revealing neurodevelopmental defects.

Type 2 diabetes: Is early control a cancer shield or a red herring?

Poor glycaemic control soon after type 2 diabetes diagnosis correlates with increased cancer risk, particularly for pancreatic and colorectal cancers.

Semaglutide: Beyond weight loss, what's the real reason it works?

Semaglutide, a GLP-1 RA, shows promise beyond obesity and diabetes, with emerging data suggesting roles in orthopedics and heart failure with preserved ejection fraction.

Type 1 diabetes: Beyond insulin, what are we missing?

Early-stage type 1 diabetes care extends beyond insulin, requiring a comprehensive approach to manage glycaemia, prevent complications, and support patient well-being.

Beyond HbA1c: What integrated diabetes care really means for organs

Managing diabetes extends beyond glucose control, requiring a holistic approach to prevent heart, kidney, and liver complications.

Beyond statins: The counterintuitive path to cutting pancreatitis risk

ApoC-III inhibition with plozasiran reduced triglycerides by 53%-58% and showed a borderline 17% reduction in pancreatitis events in severe hypertriglyceridemia.

Lipohypertrophy: It's not just cosmetic for GLP-1 patients

Suboptimal injection practices contribute to lipohypertrophy, impairing drug absorption and glycemic control in patients using insulin and GLP-1 injectables. Correct technique is essential for therapeutic efficacy.

Metabolic health: Why weight loss isn't enough for your patients

Metabolic health extends beyond simple weight loss, requiring a focus on underlying biological mechanisms that drive dysfunction. Effective interventions target insulin resistance, inflammation, and adipocyte function.

Type 1 diabetes: Why managing insulin isn't enough anymore

Teplizumab represents a significant step in autoimmune type 1 diabetes management, moving beyond insulin replacement to target disease progression itself. Its mechanism offers a new approach to preserving beta-cell function.

CKD, T2D: Why RAASi isn't enough for cardiorenal protection?

Non-steroidal mineralocorticoid receptor antagonists offer a new therapeutic avenue for cardiorenal protection, particularly in patients with chronic kidney disease and type 2 diabetes. These agents mitigate inflammation and fibrosis, addressing residual risk beyond traditional renin-angiotensin-aldosterone system inhibition.

Sex and hypoglycaemia in type 1 diabetes: what CGM data now show

Across 110 events in 12 adults with type 1 diabetes, sexual intercourse caused no clinically significant hypoglycaemia. Glucose moved in both directions, shaped by the starting level, body mass index and time of day.

Why CGM readings drift during a marathon in type 1 diabetes

In a real marathon, CGM error reached 36.6% to 43.1%, several times the figures seen in short laboratory exercise tests. Runners with type 1 diabetes finished as fast as controls, but a fingerstick still earns its place.

The enduring puzzle of diabetes remission after bariatric surgery

Bariatric surgery often leads to diabetes remission, but the mechanisms are complex and not solely due to weight loss. Understanding these pathways is essential for optimising patient outcomes.

Korlym (mifepristone) in Cushing's syndrome: why cortisol cannot guide treatment

Mifepristone blocks the glucocorticoid receptor rather than lowering cortisol, so ACTH and cortisol rise on treatment and cannot be used to judge response. Almost everything difficult about using this drug follows from that one fact.

Xiidra (lifitegrast) in dry eye disease: what the OPUS trials actually showed

Lifitegrast blocks LFA-1 binding to ICAM-1, interrupting T-cell adhesion before the inflammatory cascade begins. The OPUS programme is more nuanced than it is usually described: no single trial met both its sign and its symptom endpoint, and reading all three gives a different picture from reading one.

IPF: Why new therapies are still missing the mark

The TETON Phase 3 clinical program provides new insights into the management of idiopathic pulmonary fibrosis, highlighting both progress and persistent challenges.

Alpha-1 Antitrypsin Deficiency: Why fragmented care costs lives

Alpha-1 antitrypsin deficiency presents as both a respiratory and hepatic disease, often leading to diagnostic delays and suboptimal management due to fragmented care.

Air pollution: Why policies fail, and patients pay the price

Despite clear evidence linking air pollution to adverse health outcomes, effective implementation of protective policies remains a significant hurdle.

Respiratory care: Why neurology's long-acting therapies could be key

Insights from multiple sclerosis treatment paradigms offer a framework for developing ultra-long-acting therapies in respiratory care, addressing adherence and disease progression.

Rethink PDE inhibition in COPD: Not all isoforms are equal

Phosphodiesterase (PDE) inhibitors offer therapeutic potential in COPD, but adverse effects, particularly nausea with PDE4 inhibitors and cardiovascular risks with chronic PDE3 inhibition, limit their broader application.

RSV and COVID-19 vaccines: Why are we still underestimating their impact?

Vaccination against RSV and COVID-19 offers a critical strategy for mitigating the burden of respiratory diseases, particularly in vulnerable populations.

Severe asthma: Why targeted therapies miss some Type 2 patients

Emerging clinical insights suggest the distal airways play a more central role in Type 2 severe asthma pathophysiology than previously understood.

PH-ILD: Why current vasodilators fall short, and what's next

An inhaled sGC activator is under investigation for pulmonary hypertension associated with interstitial lung disease, a condition with significant unmet need.

Beyond rescue inhalers: What really keeps COPD patients out of hospital?

Preventing hospital admissions for COPD requires a comprehensive approach, moving beyond acute symptom management to address the underlying disease progression and comorbidities.

COPD exercise limits: Is your oxygen therapy doing enough?

High-flow humidified oxygen improved exercise endurance and reduced dyspnea in patients with advanced COPD compared to conventional low-flow oxygen.

Beyond diagnosis: ECG waveforms predict MI-E treatment response

Electrocardiogram waveforms offer insights into myocardial infarction with epicardial coronary artery disease (MI-E) efficacy, providing a non-invasive window into myocardial health.

Chronic lung disease: Why early diagnosis still isn't enough

Managing chronic lung diseases presents complex challenges, from accurate diagnosis to optimising long-term treatment strategies and addressing patient adherence.

Sleep Apnea: Why AHI Misses What Matters Most

Traditional AHI metrics often miss the full impact of sleep apnea; hypoxic burden and specific phenotyping offer a clearer picture of patient risk and device efficacy.

COPD: Why one moderate exacerbation changes everything

One moderate COPD exacerbation should prompt clinicians to consider stepping up from dual bronchodilator therapy to a single-inhaler triple therapy.

COPD: Why focusing only on exacerbations misses the bigger picture?

COPD management extends beyond preventing exacerbations, encompassing symptom burden, exercise capacity, and quality of life for a holistic patient approach.

Epithelial health: more than a symptom of chronic inflammation?

Maintaining epithelial barrier integrity is emerging as a critical factor in achieving disease remission, moving beyond traditional symptom management in chronic inflammatory conditions.

Chronic respiratory disease: Why diagnosis often comes too late

Understanding the patient journey for chronic respiratory diseases in resource-limited settings reveals significant diagnostic and treatment delays, impacting long-term outcomes.

Bronchiectasis: Why symptom control isn't enough anymore

Bronchiectasis management is evolving beyond symptomatic relief, with a focus on neutrophil-driven inflammation as a target for disease modification.

High-flow oxygen: The unexpected boost for COPD endurance?

High-flow humidified oxygen improved exercise endurance and reduced dyspnea in patients with advanced COPD compared to conventional low-flow oxygen.

Airway mucus: Is it a symptom or the disease driver in lung conditions?

Airway mucus obstruction is a central feature of many chronic lung diseases, contributing to inflammation, infection, and progressive lung damage.

Beyond the numbers: What your PFT results are really telling you

Pulmonary function tests require an approach beyond simple normal/abnormal classifications, integrating clinical context and patient demographics for accurate diagnosis.

Obesity hypoventilation: CPAP vs. NIV, the economic tension

Obesity hypoventilation syndrome (OHS) can be managed with either CPAP or NIV, with device choice impacting economics and operations.

COPD exacerbations: Why RSV's hidden role demands a new vaccine strategy

RSV infection significantly destabilizes COPD, driving exacerbations and hospitalizations. The adjuvanted RSV vaccine offers a new tool to mitigate this risk.

Pneumococcal disease: Your patients need updated protection now

Pneumococcal disease remains a significant global health burden, with new GBD 2023 data highlighting persistent mortality in vulnerable populations.

Rhinitis isn't just a nuisance: It's a key to managing asthma and COPD

Chronic inflammatory diseases of the upper and lower airways are often comorbid, sharing underlying pathophysiological mechanisms. Integrated management is essential for optimal patient outcomes.

NTM lung disease: Why are we still missing it?

Non-tuberculous mycobacterial lung disease presents significant diagnostic and therapeutic challenges, often leading to delayed intervention and suboptimal patient outcomes.

COPD: Why dual bronchodilation still isn't working for some patients

Dual bronchodilation remains a cornerstone in COPD management, focusing on symptom control and exacerbation reduction.

Pulmonary fibrosis: Why early diagnosis remains a clinical enigma

Pulmonary fibrosis presents significant diagnostic and treatment challenges, often leading to delayed intervention and poorer outcomes for patients.

Severe asthma: Why biologics aren't delivering remission

Severe asthma remission is rare, even with biologic treatments, according to a European registry study highlighting persistent disease burden.

Why targeting IL-33 could change how we manage COPD

Interleukin-33 plays a complex role in COPD pathogenesis, driving both inflammation and mucus production, which contributes to exacerbation risk.

Asthma care: Your patients need more than symptom relief

Current asthma management focuses on symptom control and exacerbation reduction, but patient-reported outcomes highlight persistent unmet needs.

Severe asthma, COPD: Why symptom control isn't enough

Managing severe asthma and COPD requires timely intervention, moving beyond symptomatic relief to address underlying inflammation and prevent exacerbations.

NIV adherence: Why patient engagement is the real determinant of outcomes

Engaging patients actively in their non-invasive ventilation (NIV) therapy improves adherence and clinical outcomes. Education, shared decision-making, and tailored support are critical for success.

Ventilation: Why static guidelines fail dynamic patients

Continuous-improvement ventilation relies on real-world data to refine protocols and enhance patient outcomes, moving beyond static guidelines.

OSA: Why AHI alone isn't predicting your patients' heart risk

The apnea-hypopnea index (AHI) remains the standard for obstructive sleep apnea diagnosis, but its limitations in predicting cardiovascular outcomes are clear.

OPEP therapy: Is your current mucus clearance falling short?

Oscillating positive expiratory pressure (OPEP) therapy offers a non-pharmacological approach to mucus clearance across various respiratory conditions.

Pulmonary alveolar proteinosis: It's not surfactant overproduction

Autoimmune pulmonary alveolar proteinosis (aPAP) results from impaired GM-CSF signaling, leading to surfactant accumulation. Management focuses on whole lung lavage, but targeted therapies are emerging.

Pulmonary alveolar proteinosis: Your patients deserve better

Pulmonary alveolar proteinosis (PAP) management across Europe faces significant disparities, driven by varied access to diagnostic tools and treatment modalities. A unified approach is critical for improving patient outcomes.

Pulmonary Hypertension: Why are we still going systemic?

Inhaled therapies are increasingly central to managing pulmonary arterial hypertension and pulmonary hypertension associated with interstitial lung disease, offering targeted delivery and reduced systemic side effects.

Pulmonary Hypertension: Your objective measures aren't telling the whole story

Patient-reported outcomes are essential for understanding the true burden of pulmonary arterial hypertension and guiding treatment decisions.

Alpha-1 Antitrypsin Deficiency: Beyond augmentation, a new path

Advancements in Alpha-1 Antitrypsin Deficiency (AATD) therapies focus on restoring functional AAT levels and achieving clinically meaningful endpoints beyond simple protein augmentation.

Why treating asthma and CRSwNP separately may fail your patients

Anosmia, or loss of smell, may serve as a crucial indicator of shared inflammatory pathways between asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), suggesting a unified airway disease. Its presence signals a systemic type 2 inflammatory burden that impacts treatment decisions and patient quality of life.

Respiratory inhalers: The hidden climate cost of patient care?

Addressing the environmental impact of respiratory care, particularly inhaler use, is becoming a critical consideration for clinical practice.

COPD: Early aggressive therapy isn't just for lungs

Delayed optimisation of COPD management leads to significant adverse cardiopulmonary outcomes, underscoring the need for earlier, aggressive therapeutic strategies.

Severe asthma, CRSwNP: Why targeting TSLP upstream changes everything

Thymic stromal lymphopoietin (TSLP) inhibition offers a novel strategy for epithelial-driven inflammatory diseases like severe asthma and chronic rhinosinusitis with nasal polyps.

Pulmonary fibrosis: Is inflammation friend or foe?

Fibrotic interstitial lung diseases involve intertwined inflammation and fibrosis, with varying contributions that demand personalized treatment approaches.

Asthma, COPD: Why the 'right' drug often fails in the 'wrong' device

Matching the right inhaler device to a patient's needs remains a persistent challenge in respiratory care, despite a wide array of available options.

Stop missing ILD: AI reveals what the eye can't see

Integrating artificial intelligence with clinical expertise can accelerate the identification of interstitial lung disease, potentially improving patient outcomes.

Asthma: Why are we still guessing when omics can personalize care?

New reviews highlight how omics technologies and artificial intelligence are transforming asthma diagnosis, prognosis, and treatment decisions, moving beyond empirical approaches.

Long-term oxygen therapy: Are we missing the patient experience?

A new questionnaire, QuOTE, offers a simple, patient-reported method to evaluate the impact of long-term oxygen therapy on daily life. This tool provides a direct measure of patient experience, which has been historically difficult to quantify.

COPD & asthma: Why symptom control isn't enough anymore

Current management of COPD and asthma focuses on symptom control, but emerging strategies aim to alter disease progression itself.

Rethinking PCV: Not all conjugate vaccines are equal for chronic lung disease

Real-world evidence on pneumococcal conjugate vaccines (PCVs) highlights differential effectiveness in adults with chronic lung disease.

Personalized COPD care: Is your current approach missing the mark?

New approaches to chronic obstructive pulmonary disease (COPD) management focus on phenotype-guided therapies and early intervention strategies.

Rethinking COPD: Dupilumab shows type 2 inflammation matters

Dupilumab has demonstrated efficacy in both asthma and COPD, offering a new therapeutic avenue for patients with underlying type 2 inflammation.

Pulmonary hypertension: Are we missing a key driver of vascular remodeling?

The insulin-like growth factor (IGF) family contributes to vascular remodeling and endothelial dysfunction in PAH, suggesting potential as diagnostic biomarkers and therapeutic targets.

Eosinophil depletion: Why 'good enough' isn't enough anymore

Near-complete depletion of eosinophils is critical for optimal outcomes in eosinophil-driven diseases, moving beyond simple reduction to target the underlying pathogenic mechanism.

COPD: Why are we still missing early diagnoses?

Chronic obstructive pulmonary disease often goes undiagnosed until advanced stages, delaying interventions that could improve patient outcomes. Identifying at-risk individuals earlier is critical for effective management.

Rethinking asthma control: Why 'stable' isn't always enough

Achieving rapid and sustained control of asthma symptoms is critical for preventing exacerbations and improving long-term patient outcomes.

IPF, PPF: Why patient and clinician views on disease impact diverge

Idiopathic pulmonary fibrosis and progressive pulmonary fibrosis present unique challenges, with patient and pulmonologist perspectives often misaligned on disease impact and management.

Why CPAP success isn't about the device, but the patient experience

Optimising CPAP therapy requires a shift from device-centric views to patient-centred care, addressing comfort, education, and ongoing support.

Central sleep apnea: Why aren't we using ASV more?

Auto-servo ventilation (ASV) therapy is a guideline-recommended treatment for central sleep apnea (CSA), but its adoption in clinical practice remains inconsistent. Understanding ASV's mechanism and patient selection is important for optimal outcomes.

Bronchoscopy training: Why 'hundreds of procedures' may no longer be enough

AI integration into flexible bronchoscopy training aims to improve procedural proficiency and diagnostic accuracy for respiratory specialists.

CRRT: Is earlier liberation better for young patients?

Early liberation from continuous renal replacement therapy (CRRT) may offer benefits for younger patients, potentially reducing complications and improving outcomes.

Rheumatology care: Is lower drug cost worth limited access?

A new CMS drug pricing rule could lead to unintended consequences for patients with rheumatic diseases, according to the American College of Rheumatology.

Bariatric surgery: Why age changes substance use outcomes

Bariatric surgery reduced psychoactive substance use in young adult women but not adolescents, while improving depression and social anxiety in adolescents.

Graves' disease: Why less antithyroid drug may be more

Adding L-carnitine and selenium to methimazole in Graves' disease significantly reduced antithyroid drug requirements and accelerated TRAb negativity.

Early menopause: A hidden driver of hypertension risk?

Women experiencing menopause at a younger age face an elevated risk of developing hypertension, according to observational data.

Hearing aids: Why are patients still saying no?

Legato Frames, a new device integrating speakers into eyeglasses for hearing loss, will soon be available. This technology aims to offer an alternative to traditional hearing aids.

Why are more children ending up in ICU for asthma?

Intensive care unit admissions for asthma in children increased from 2013 to 2022, indicating a concerning shift in asthma severity.

Trikafta: Is lifelong therapy always necessary for CF lung function?

Discontinuing chronic Trikafta therapy does not appear to diminish lung function in patients with cystic fibrosis, challenging assumptions about long-term adherence.

Lead in tampons: Is there a hidden risk for your patients?

Recent reports of lead detection in tampons have raised concerns, but current data indicates no established safety signals for patients.

Mounjaro: Is a dual agonist the new standard for CV protection?

Mounjaro (tirzepatide) received approval to reduce major adverse cardiovascular events in adults with type 2 diabetes, adding a dual GIP/GLP-1 agonist to the CV risk reduction arsenal.

Fibromyalgia: Why vagal nerve stimulation is gaining traction

Non-invasive neuromodulation, specifically transcutaneous vagal nerve stimulation, shows promise in improving fibromyalgia pain, offering a new avenue for managing this complex chronic condition.

PPIs and cancer: Is CYP2C19 a friend or foe?

Genetic ancestry influences colorectal cancer risk through proton pump inhibitor metabolism, with CYP2C19 showing opposing roles in carcinogenesis versus precancerous states.

Endocarditis: Why fixed-dose ampicillin often misses the mark

A personalized antibiotic strategy, guided by therapeutic drug monitoring, optimizes ampicillin regimens in enterococcal bloodstream infections and endocarditis.

Dermatomyositis: Why an oral JAK inhibitor changes everything

The FDA approved Lisraya, the first oral Janus kinase inhibitor for dermatomyositis, offering a new systemic treatment option for this rare autoimmune disease.

Gender-affirming hormones: Bone density gains for some, losses for others?

Gender-affirming hormone therapy significantly increased lumbar spine bone mineral density in transgender teens assigned male at birth.

Dialysis costs: Medicare as primary payer could save $1 billion

The Medicare Secondary Payer Act modestly reduced federal dialysis spending, but only when private prices were less than 3.05 times Medicare rates.

LAA occlusion: Less bleeding, but is stroke risk truly equal?

Left atrial appendage occlusion (LAAO) reduces nonprocedural bleeding in AF patients but shows no difference in stroke or mortality compared to medical therapy.

Eplontersen for ATTR-CM: Why a promising therapy fell short

Eplontersen, when added to standard care, did not demonstrate additional cardiovascular benefit for patients with ATTR-CM. The therapy's impact on cardiac outcomes remains unconfirmed.

Bixlenvo: Is the smallest HIV pill also the biggest advantage?

The FDA has approved Bixlenvo, a new single-pill regimen for HIV, notable for its compact size. This approval offers a new option for treatment-naïve adults and adolescents.

E-scooter head injuries: Why are urban trauma centers seeing more?

Head injuries are the most common and severe trauma associated with e-scooter use in inner-city settings, according to a recent study.

Titration: Why 'Start Low, Go Slow' Isn't Always the Safest Path

Optimal drug titration balances efficacy and tolerability, but patient-reported signals and clinical plateaus often complicate dose adjustments. Understanding these dynamics is essential for achieving therapeutic goals.

Menopausal Hormone Therapy: A Cost-Effective Path to Better Health?

Menopausal hormone therapy may offer significant health benefits while simultaneously reducing healthcare costs, challenging some long-held perceptions about its value.

Your white coat isn't the authority it once was. What is?

The traditional white coat, once a universal symbol of medical authority, has seen its prominence wane in clinical settings, replaced by scrubs and the simple passage of time.

GLP-1s: Weight down, but steps down too? The paradox clinicians face

GLP-1 receptor agonists drive significant weight loss, but some patients experience a concurrent reduction in physical activity.

DOACs for AFib: Are intermediate-risk patients getting the protection they need?

Direct oral anticoagulants (DOACs) reduce clinical events in atrial fibrillation patients at intermediate stroke risk, challenging prior assumptions about optimal management in this group.

Beyond diabetes: Semaglutide's surprising signal in bipolar disorder

Semaglutide, a GLP-1 receptor agonist, shows an unexpected signal for mood stabilization in patients with bipolar disorder, raising questions about its broader therapeutic potential.

GLP-1s and hair loss: Is it the drug or the diet?

Rapid weight loss from GLP-1 receptor agonists can trigger telogen effluvium, a temporary hair shedding condition. Clinicians should counsel patients on this potential side effect and its management.

Dolutegravir for HIV in newborns: A new option for an urgent need

Dolutegravir, an integrase strand transfer inhibitor, has received FDA approval for treating HIV-1 infection in newborns and infants.

BPH: Why alpha-blockers aren't always enough

Benign prostatic hyperplasia management in primary care extends beyond initial pharmacotherapy, requiring a careful approach to diagnosis, patient selection, and advanced interventions.

For Everyday Shoulder Pain, Less Treatment Is Often More

Conservative management, emphasizing education and activity modification, frequently outperforms aggressive interventions for common shoulder pain.

When is that wilting produce still safe to eat, and when is it a hazard?

Knowing when to discard fruit and vegetables is essential for preventing foodborne illness. Visual cues and texture changes are reliable indicators of spoilage.

Is the global loneliness epidemic a real phenomenon or a perception problem?

Research into global loneliness reveals a complex picture, challenging the notion of a universal epidemic and highlighting regional and demographic variations.

Your unread medical textbooks aren't a failure, they're a psychological tool

The phenomenon of acquiring books without reading them, known as tsundoku, offers psychological benefits related to aspiration and potential.

Could immune system modulation be the next frontier in skincare?

Emerging research suggests that targeting immune pathways could offer novel strategies for managing chronic skin conditions, moving beyond symptomatic relief.

Perimenopause and chest pain: When to suspect cardiac causes

Chest symptoms in perimenopausal women often mimic cardiac events, complicating diagnosis. Clinicians must differentiate benign presentations from urgent cardiovascular concerns.

Why vaccine skepticism thrives despite overwhelming data

Vaccine skepticism often thrives on narrative structures that bypass scientific evidence, creating powerful, emotionally resonant messages that challenge public health efforts.

Undiagnosed TB deaths in England highlight diagnostic failures

Hundreds of individuals in England have died from tuberculosis without receiving a diagnosis, underscoring critical gaps in public health surveillance and clinical detection pathways.

Milvexian fails to cut ischemic risk in recent ACS, raising questions for FXIa inhibitors

Milvexian did not reduce ischemic events in patients with recent acute coronary syndrome, despite its mechanism as a factor XIa inhibitor.

ICD-11: What European GPs need to know about the new classification system

The ICD-11 system introduces significant changes to disease classification, impacting coding for conditions like hidradenitis suppurativa and neonatal encephalopathy.

Biomarkers predict early rhythm control benefit in AFib

Early rhythm control's benefit in atrial fibrillation varies by baseline biomarker levels, with higher NT-proBNP and hs-cTnT indicating greater risk reduction.

Serology and PCR: Optimising COVID-19 Episode Identification

Integrating serology with PCR and rapid antigen tests improves COVID-19 episode identification, particularly in vaccinated individuals, according to BRACE trial insights.

Navigating Dilated Cardiomyopathy: Beyond Standard Care

Dilated cardiomyopathy management focuses on symptom control, preventing disease progression, and reducing adverse cardiac events through guideline-directed medical therapy.

Noninvasive Ventilation: A Shift in End-of-Life Care for ALS?

Noninvasive ventilation may reduce requests for medical assistance in dying (MAiD) among patients with amyotrophic lateral sclerosis (ALS). This suggests a potential impact on end-of-life decisions.

Traditional Chinese Medicines Plus Metformin: An A1c Advantage?

Combining Traditional Chinese Medicines with metformin may offer additional A1c reductions for patients with type 2 diabetes.

Atorvastatin's CV Benefit in Older Adults: More Nonfatal Events Than Deaths?

Atorvastatin reduces major cardiovascular events in older adults, with the benefit primarily driven by a reduction in nonfatal events rather than mortality.

Statins: When to start primary prevention after age 70?

Statins can reduce the risk of first heart attack and stroke by approximately 30% in individuals over 70 years of age.

Bilateral Focused Ultrasound: A New Path for Parkinson's Motor Control?

Staged, bilateral MRgFUS pallidothalamic tractotomy significantly improved motor complications in Parkinson's disease, offering an incisionless alternative to DBS.

Dual-target gene therapy: Can it free Parkinson's patients from levodopa dependence?

A dual-target gene therapy, BBM-P002, demonstrated a favorable safety profile in a Phase 1 trial for moderate-to-advanced Parkinson's disease.

Repatha before PCI for acute MI: Better lipids, but no better outcomes

Pre-PCI Repatha improves lipid profiles in acute MI patients but does not translate into a reduction in major adverse cardiovascular events.

Olorofim shows promise against resistant invasive fungal disease

Olorofim, a novel orotomide antifungal, demonstrated efficacy and safety in a Phase 2b study for invasive fungal diseases with limited treatment options.

Duchenne Muscular Dystrophy: Why silent cardiac decline costs lives

Regular, proactive cardiac and respiratory monitoring is essential for Duchenne muscular dystrophy patients, directly impacting survival rates. Adherence to established guidelines for surveillance can mitigate the progression of life-limiting complications.

Duchenne gene therapy: Is micro-dystrophin enough for functional gains?

Delandistrogene moxeparvovec, an AAV micro-dystrophin gene therapy, gained US FDA approval but its clinical benefit against functional endpoints remains under scrutiny.

Pompe disease NBS: Is early diagnosis a false promise?

Newborn screening for Pompe disease identifies infants with acid alpha-glucosidase deficiency, but pseudodeficiency alleles complicate early diagnosis and treatment decisions.

Late-onset Pompe: Why respiratory distress often fools us

Late-onset Pompe disease often presents with respiratory compromise before limb weakness becomes overt, challenging diagnostic timelines and delaying enzyme replacement therapy.

Pompe disease ERTs: Are incremental gains enough for your patients?

New enzyme replacement therapies for Pompe disease, avalglucosidase alfa and cipaglucosidase alfa, offer incremental improvements over older treatments.

Low-risk thyroid cancer: Time to rethink radioactive iodine?

Forgoing radioactive iodine therapy in select low-risk thyroid cancer patients does not increase recurrence rates, challenging a long-held treatment paradigm.

Papillary thyroid microcarcinoma: When less is more

Active surveillance for low-risk papillary thyroid microcarcinoma shows comparable long-term oncological outcomes to immediate surgery, with significantly fewer interventions.

PD-L1 isn't just a biomarker for HNSCC, it's a treatment guide

PD-L1 expression guides immunotherapy selection in recurrent and metastatic head and neck squamous cell carcinoma, with varying efficacy across patient subgroups.

HPV-positive OPSCC: Are we overtreating excellent prognoses?

Treatment de-escalation strategies for HPV-positive oropharyngeal cancer aim to reduce toxicity while maintaining efficacy, with ongoing trials exploring various approaches.

Ovarian cancer: Early detection isn't the answer we thought

Ovarian cancer continues to be diagnosed at advanced stages, despite decades of research into effective screening methods. The disease's insidious nature and lack of reliable early detection tools contribute to poor outcomes.

Vertebral Fractures: Why Radiologists See Them, But Clinicians Miss Them

Vertebral fragility fractures are frequently visible on routine imaging but often go unrecognised by clinicians, leading to delayed diagnosis and treatment.

Why a first fracture often leads to another: The FLS gap in secondary prevention

Despite the known risk, many patients who experience a fragility fracture do not receive adequate secondary prevention, leaving a critical care gap.

Cemented fixation in hip fracture: Is the cardiopulmonary risk real?

Cemented fixation in hip fracture arthroplasty does not increase cardiopulmonary complications, a secondary analysis of the HIP ATTACK trial showed.

Why spinal stenosis imaging often fails to explain patient symptoms

Imaging findings in spinal stenosis frequently do not align with patient-reported symptoms, creating diagnostic and therapeutic challenges for clinicians.

Lumbar spinal stenosis: Why symptoms, not imaging, should guide surgery

Clinical symptoms, not radiographic findings, dictate surgical candidacy and outcomes in lumbar spinal stenosis, a review confirms. Imaging severity often poorly correlates with patient-reported disability.

Why 12-month biochemical response is the critical pivot in endocrine disease

Assessing biochemical response at 12 months is a key decision point across several endocrine conditions, setting the long-term prognostic trajectory for patients.

Fusion for Degenerative Spondylolisthesis: More Harm Than Help?

Lumbar decompression with fusion significantly increases mortality and morbidity compared to decompression alone in older adults with degenerative lumbar disease.

Why adults with severe hearing loss often miss out on cochlear implants

Cochlear implantation remains heavily underused in adults with severe-to-profound hearing loss, despite established benefits and guideline recommendations.

OTC hearing aids: When convenience isn't enough for hearing loss

Over-the-counter hearing aids offer accessibility but fall short for complex hearing loss, requiring careful patient counselling on their limitations.

Seladelpar and elafibranor: second-line options for PBC

For patients with primary biliary cholangitis (PBC) who do not respond adequately to ursodeoxycholic acid, seladelpar and elafibranor offer new therapeutic avenues.

Does treating hearing loss actually slow cognitive decline?

Addressing hearing loss with hearing aids or cochlear implants may reduce cognitive decline in older adults at higher risk.

Otitis media: Can shorter antibiotic courses truly deliver?

Shorter antibiotic courses for acute otitis media aim to reduce resistance, but their efficacy often falls short in specific patient populations, raising questions about optimal treatment duration.

Tympanostomy tube referrals: Why thresholds vary more than the evidence does

Referral criteria for tympanostomy tube insertion in children with recurrent acute otitis media or otitis media with effusion show significant variability across guidelines, despite a largely consistent evidence base. This disparity can lead to inconsistent patient care and unnecessary procedures.

Borderline personality disorder: where medication helps and where it does not

Off-label prescribing for psychiatric inpatients with intellectual disability is common, with psychotropics frequently used for unlicensed indications.

Watchful Waiting in AOM: Which Children Can Safely Wait?

Watchful waiting is a safe strategy for acute otitis media in specific pediatric populations, reducing antibiotic exposure without increasing complications.

Why benign paroxysmal positional vertigo remains undertreated despite quick fixes

Benign paroxysmal positional vertigo (BPPV) is a common cause of dizziness, yet its effective, rapid treatments are frequently underutilised in clinical practice.

Why HINTS examination outperforms imaging for acute vertigo

The HINTS examination accurately differentiates central from peripheral vertigo, reducing unnecessary neuroimaging in emergency department patients.

Vestibular rehabilitation: Which protocols deliver lasting relief?

Vestibular rehabilitation protocols vary widely, but specific approaches focusing on adaptation, habituation, and substitution are critical for durable patient benefit.

Hypoglossal Nerve Stimulation: Beyond AHI for OSA Patient Selection

Patient selection for hypoglossal nerve stimulation in obstructive sleep apnea must extend beyond the apnea-hypopnea index, considering anatomical factors and broader health impacts.

Tirzepatide in OSA: What SURMOUNT-OSA means for management

Tirzepatide demonstrated a reduction in the apnea-hypopnea index in patients with obstructive sleep apnea, offering a new therapeutic avenue for a condition often linked to metabolic dysfunction.

Navigating SMA Treatment: What Parents Prioritise in Newborn Screening Decisions

Parents choosing spinal muscular atrophy treatments for infants diagnosed via newborn screening weigh efficacy, administration, and long-term impact.

Newborn screening: How much function can presymptomatic treatment truly preserve?

Presymptomatic treatment after newborn screening aims to mitigate disease progression, but the extent of preserved function varies significantly across conditions.

Esketamine vs. Quetiapine: Which Augmentation Strategy for TRD?

A head-to-head trial compared esketamine and quetiapine as augmentation strategies for treatment-resistant depression, offering insights into their relative efficacy and tolerability.

Fabry Disease: Why Women Were Left Behind in Diagnosis and Treatment

Women with Fabry disease have historically faced significant diagnostic delays and undertreatment, stemming from outdated genetic assumptions and a lack of recognition of their diverse clinical presentations.

Fabry Disease: Why Early Recognition in Cardiology and Nephrology Clinics Remains Elusive

Fabry disease often presents with non-specific cardiac and renal symptoms, leading to significant diagnostic delays. Increased awareness and targeted screening in high-risk populations are essential for timely intervention.

Migalastat vs. ERT: How Fabry Chaperone Therapy Stacks Up

Migalastat, an oral chaperone, demonstrated non-inferiority to enzyme replacement therapy (ERT) in Fabry disease patients with amenable GLA mutations, offering a potential oral alternative.

Givinostat: Targeting the Downstream Disease in Duchenne Muscular Dystrophy

Givinostat, a histone deacetylase inhibitor, offers a non-genetic approach to Duchenne muscular dystrophy by addressing downstream disease mechanisms.

Duchenne Muscular Dystrophy: The Cardiac and Respiratory Surveillance That Changes Survival

Regular, proactive cardiac and respiratory monitoring is critical for Duchenne muscular dystrophy patients, directly impacting survival and quality of life.

Delandistrogene Moxeparvovec: Are Functional Endpoints Meeting Duchenne Expectations?

Delandistrogene moxeparvovec, an AAV micro-dystrophin gene therapy, has US FDA approval for Duchenne muscular dystrophy, but clinical benefit remains a point of contention.

Deep TMS for OCD: How durable is the response in treatment-resistant patients?

Deep transcranial magnetic stimulation offers a non-invasive option for treatment-resistant OCD, but questions remain about the long-term durability of its effects.

Why the heart team model is non-negotiable as structural options multiply

The escalating complexity of structural heart disease management demands a robust, multidisciplinary heart team approach to optimise patient outcomes and navigate expanding therapeutic options.

RET-altered thyroid cancer: how selective inhibitors changed advanced disease

The advent of selective RET inhibitors has significantly improved outcomes for patients with advanced RET-altered thyroid cancer. These targeted therapies address a critical unmet need in a previously challenging disease landscape.

Radioactive iodine: Which low-risk thyroid cancer patients can safely skip it?

For low-risk differentiated thyroid cancer, selective use of radioactive iodine ablation is a viable strategy, sparing many patients unnecessary treatment.

Tricuspid regurgitation: Navigating the least settled valve decision

Selecting patients for tricuspid valve intervention remains a complex clinical challenge, with evolving understanding of disease progression and optimal timing.

Active Surveillance for Papillary Thyroid Microcarcinoma: A Decade of Data

Active surveillance for low-risk papillary thyroid microcarcinoma shows comparable long-term oncological outcomes to immediate surgery, with significantly fewer interventions.

TAVI in low-risk patients: How long will the valves actually last?

Transcatheter aortic valve implantation (TAVI) has expanded to younger, low-risk patients, but long-term durability data remains a critical question. Accumulating evidence suggests favorable outcomes, but ongoing monitoring is essential.

Endocarditis: Why a multidisciplinary team referral is a matter of life and death

A multidisciplinary team approach to infective endocarditis management is consistently associated with improved patient outcomes, particularly reduced mortality. Early referral to an 'endocarditis team' is a critical intervention.

PD-L1 as a compass for immunotherapy in head and neck cancer

PD-L1 expression levels guide selection for immunotherapy in recurrent and metastatic head and neck squamous cell carcinoma, impacting treatment efficacy.

Duke-ISCVID 2023: What changed for endocarditis diagnosis at the bedside?

The 2023 Duke-ISCVID criteria update refined diagnostic pathways for infective endocarditis, integrating advanced imaging and microbiological techniques to improve accuracy.

Managing the lasting damage of head and neck cancer treatment

Chemoradiation for head and neck cancers often leaves patients with chronic dysphagia and osteoradionecrosis, requiring complex, multidisciplinary management strategies.

Partial oral antibiotics for endocarditis: What POET proved, and what it did not

The POET trial established noninferiority for partial oral antibiotic therapy in stable left-sided endocarditis, but it did not compare outpatient strategies.

De-escalation in HPV-positive oropharyngeal cancer: What trials have settled

Treatment de-escalation strategies for HPV-positive oropharyngeal cancer aim to reduce toxicity while maintaining efficacy, with ongoing trials exploring various approaches.

Why patient-reported outcomes rarely make it onto drug labels

Despite their clinical relevance, patient-reported outcomes (PROs) face significant hurdles in gaining regulatory approval for inclusion on drug labels.

Why ovarian cancer is still diagnosed late, despite decades of screening research

Despite extensive research into screening methods, ovarian cancer continues to be diagnosed at advanced stages, limiting treatment efficacy.

Folate Receptor Alpha Testing: Why Timing Matters in Platinum-Resistant Ovarian Cancer

Folate receptor alpha expression in ovarian cancer can change over time, complicating treatment decisions for mirvetuximab soravtansine in platinum-resistant disease.

PARP Inhibitors in Ovarian Cancer: HRD Status Dictates Maintenance Benefit

PARP inhibitors have transformed ovarian cancer treatment, but homologous recombination deficiency status critically determines their long-term efficacy.

Do patient-reported outcomes actually improve survival?

Routine symptom monitoring with patient-reported outcomes does not improve survival, despite its perceived benefits in quality of life.

How regulatory guidance on real-world evidence changed drug submissions

Regulatory bodies have refined their expectations for real-world evidence, pushing sponsors to integrate these data earlier and more strategically into drug development programs.

Why do prediction models for prolonged air leak keep failing?

Existing prediction models for prolonged air leak after pulmonary surgery lack clinical utility and translation potential, a systematic review found.

Antibiotics for endodontic infection: when they add nothing but resistance

Antibiotic prescribing for endodontic infections often provides no additional clinical benefit over local treatment, contributing to antimicrobial resistance.

Root Canal Treatment: Does One Visit Really Compare to Two?

Single-visit root canal therapy delivers comparable postoperative pain and complication rates to multiple-visit protocols in mandibular molars.

Powered versus manual brushing: The real-world effect on oral health

Powered toothbrushes consistently outperform manual brushing in plaque removal and gingivitis reduction, with evidence suggesting superior long-term oral health outcomes.

Reversing gingivitis: What actually changes patient behaviour?

Gingivitis, if left untreated, progresses to periodontitis, a leading cause of tooth loss. Effective reversal hinges on sustained patient adherence to oral hygiene, a challenge often underestimated.

Chlorhexidine vs. essential oils: Which rinse actually cleans up gingivitis?

Chlorhexidine remains the gold standard for plaque and gingivitis reduction, outperforming essential oils and cetylpyridinium chloride in head-to-head comparisons.

Periodontitis and Heart Disease: What the Evidence Actually Supports

Periodontitis associates with cardiovascular disease through shared inflammatory pathways, but direct causality and intervention benefits remain unproven.

Applying the New Periodontitis Classification in General Practice

The 2017 classification system for periodontitis offers a more precise framework for diagnosis and management, moving beyond the traditional chronic versus aggressive dichotomy.

Periodontal Treatment: A Neglected Lever for Glycaemic Control in Type 2 Diabetes?

Nonsurgical periodontal therapy reduces inflammatory markers and improves clinical outcomes in type 2 diabetes patients with chronic periodontitis.

Do biosimilar switching studies show any real efficacy or immunogenicity signal?

Biosimilar switching studies consistently show no significant differences in efficacy or immunogenicity compared to reference biologics.

HPV-driven oropharyngeal cancer: When smoking complicates a 'good' prognosis

HPV-associated oropharyngeal squamous cell carcinoma carries a better prognosis than HPV-negative disease, but smoking history significantly worsens outcomes, complicating de-escalation strategies.

Europe's Cervical Cancer Elimination Targets: A Reality Check

Most European countries lack the robust screening registries needed to meet WHO cervical cancer elimination targets, hindering progress despite HPV testing and vaccination efforts.

HPV Self-Sampling: Is It Finally Ready for Prime Time in Cervical Screening?

HPV self-sampling demonstrates comparable accuracy to clinician-collected samples for detecting high-grade cervical lesions, significantly improving screening uptake among under-screened populations.

Which oral lesions demand biopsy, and which can wait for review?

Distinguishing oral potentially malignant disorders requiring immediate biopsy from those suitable for watchful waiting remains a clinical challenge.

Do adjunctive devices improve oral cancer detection over conventional examination?

Adjunctive optical imaging systems have not yet shown superior sensitivity or specificity over conventional oral examination for early oral cancer detection.

Direct-to-consumer orthodontics: When convenience becomes a clinical complication

Direct-to-consumer orthodontic treatments offer convenience but frequently lead to complex malocclusions and periodontal issues, requiring specialist intervention.

Early Orthodontic Intervention: When Does Two-Phase Treatment Truly Benefit?

Early interceptive orthodontic treatment, a two-phase approach, aims to correct developing malocclusions, but its genuine benefit is limited to specific clinical presentations.

Clear Aligners vs. Fixed Braces: Which Orthodontic Movements Are Truly Reliable?

Clear aligners offer aesthetic advantages, but their ability to achieve complex orthodontic movements reliably differs from traditional fixed appliances. Certain tooth movements remain more predictable with conventional braces.

Navigating dental trauma in children: How guidelines handle the immature apex

Managing dental trauma in children with immature apices presents unique challenges, requiring careful consideration of pulp vitality and root development.

Maternal Mortality: Which Interventions Actually Move the Numbers?

Addressing maternal mortality disparities requires targeted interventions. Evidence suggests that systemic changes, rather than isolated clinical efforts, drive meaningful reductions.

Avulsed Permanent Tooth: The Critical First Hour for Salvage

Immediate, precise management of an avulsed permanent tooth within the first 60 minutes dictates its prognosis. Replantation success hinges on rapid, correct handling and storage.

Maternal sepsis: why vital sign patterns in pregnancy often mislead

Recognising sepsis in pregnant patients is complicated by physiological changes that mask classic vital sign abnormalities, delaying critical intervention.

Propolis extract: A new contender for preserving avulsed teeth?

Thai propolis extract maintained periodontal ligament cell viability and gene expression, suggesting a potential role in improving avulsed tooth replantation outcomes.

Erosive Tooth Wear: Why Younger Adults Face a Growing Dental Threat

Erosive tooth wear is increasingly prevalent in younger adults, driven by dietary acids and gastroesophageal reflux disease. Clinicians report a rise in cases, necessitating early intervention.

Erosion, Attrition, Abrasion: Why the Cause Changes the Dental Plan

Distinguishing between dental erosion, attrition, and abrasion is critical for effective management, as each type of wear demands a distinct therapeutic approach.

Can the Basic Erosive Wear Examination Index Predict Progression in Children?

Age-specific risk prediction models for erosive tooth wear in preschool children identified distinct factors for 3-year-olds and 5-year-olds, challenging a universal index.

Fabry Disease: When Enzyme Replacement Isn't Enough for Glycosphingolipid Buildup

Fabry disease treatment decisions now extend beyond enzyme replacement, incorporating chaperone therapy, substrate reduction, and gene therapy for optimal patient outcomes.

Late-Onset Presentations: When Adult Symptoms Mask Childhood Conditions

Adult clinics frequently encounter late-onset presentations of conditions traditionally associated with childhood, demanding a re-evaluation of diagnostic frameworks.

The Unending Debate: One-Step Versus Two-Step Screening

A persistent disagreement continues in medical screening protocols, with no clear resolution on whether a single, comprehensive test or a staged approach offers superior outcomes.

Newborn screening for lysosomal storage disorders: what earlier detection changes

Earlier detection of lysosomal storage disorders like Hunter syndrome and metachromatic leukodystrophy through newborn screening offers a critical window for intervention.

Recurrent UTIs in women: What works when antibiotics are no longer enough?

New strategies are emerging for recurrent urinary tract infections in women, moving beyond antibiotics to address persistent symptoms and reduce recurrence rates.

Asymptomatic bacteriuria: The treatment decision that fuels antibiotic resistance

Treating asymptomatic bacteriuria often leads to unnecessary antibiotic exposure, driving resistance without improving patient outcomes. Guidelines consistently advise against routine treatment in most populations.

Gepotidacin: A New Oral Option for Uncomplicated UTIs in Adolescents

Gepotidacin, a first-in-class oral antibiotic, received approval in 2025 for uncomplicated UTIs in female patients aged 12 years and older and weighing at least 40 kg.

When minimally invasive BPH therapies fail, what's next?

Minimally invasive surgical therapies for BPH offer sexual function preservation, but retreatment rates vary. Repeat MIST is feasible for BPH recurrence.

BPH treatment: The sexual side effects clinicians must discuss

Counselling patients on potential ejaculatory and sexual side effects before initiating BPH treatment, particularly 5α-reductase inhibitors, is critical for informed consent and adherence.

Aquablation vs. TURP: Ejaculatory Function Durability in BPH

Robotic waterjet ablation (Aquablation) preserves antegrade ejaculation in BPH patients at significantly higher rates than TURP, with durability up to five years.

Why syphilis rates keep climbing in high-income countries

Syphilis incidence continues to rise across high-income nations, driven by complex shifts in sexual health practices and public health infrastructure.

Congenital Syphilis: The Missed Opportunities Behind Rising Case Counts

Congenital syphilis cases are rising, driven by missed maternal screening and inadequate treatment during pregnancy. Early and repeated testing is critical to prevent severe neonatal outcomes.

Doxycycline PEP: When it works for STIs, and when it doesn't

Doxycycline post-exposure prophylaxis reduces bacterial STIs in high-risk groups, but efficacy varies by pathogen, raising concerns about antimicrobial resistance.

Clade I outbreak: Where did the vaccine supply go?

The recent clade I outbreak highlighted significant disparities in vaccine access, with supply disproportionately allocated to certain regions.

Mpox: Why the classic rash is no longer the only sign

Mpox cases continue to be reported globally, with atypical presentations challenging traditional diagnostic approaches and requiring enhanced surveillance.

Intranasal epinephrine: Does it stack up to the intramuscular standard?

Intranasal epinephrine (neffy) achieved comparable pharmacokinetic profiles to intramuscular epinephrine in allergic rhinitis patients, suggesting a needle-free option for severe allergic reactions.

Tecovirimat in clade I mpox: why PALM007 did not show benefit

Tecovirimat did not demonstrate a clinical benefit in patients with clade I mpox, failing to reduce time to lesion healing or improve clinical outcomes.

The hidden costs of a false penicillin allergy label

Mislabeling penicillin allergy drives increased healthcare costs, worse patient outcomes, and contributes to antimicrobial resistance.

IBD overlap changes colorectal cancer screening for rare subtypes

Inflammatory bowel disease significantly worsens recurrence-free survival in rare colorectal carcinoma subtypes, particularly enteroblastic CRC, necessitating revised screening protocols.

Cholangiocarcinoma Surveillance: What Interval, What Modality in PSC?

Annual surveillance for cholangiocarcinoma in primary sclerosing cholangitis patients should include noninvasive imaging and serum CA 19-9, according to expert recommendations.

Unmasking Penicillin Allergy: A Workflow for the Non-Allergist

Many patients carry an unsubstantiated penicillin allergy label, leading to suboptimal antibiotic choices. A structured delabelling workflow, implementable by generalists, can safely remove these labels.

Why primary sclerosing cholangitis remains a therapeutic graveyard

Despite numerous attempts, no disease-modifying therapy has succeeded in primary sclerosing cholangitis, leaving transplant as the only definitive treatment.

Direct Oral Challenge: A Simpler Path to Delabeling Low-Risk Penicillin Allergies?

Direct oral challenge is noninferior to skin testing for delabeling low-risk penicillin allergies, offering a simpler approach in various clinical settings.

Pruritus in primary biliary cholangitis: the symptom that drives quality of life

Pruritus significantly impacts quality of life in primary biliary cholangitis, driving patient-reported outcomes and necessitating targeted management strategies.

Biochemical Response at 12 Months: The Prognostic Crossroads

Assessing biochemical response at 12 months is a critical decision point in chronic disease management, setting long-term prognosis and guiding therapeutic adjustments.

Allergen introduction: Has clinical practice truly shifted?

Despite updated guidelines recommending early allergen introduction, uptake in clinical practice has been slow and inconsistent, leaving many children at continued risk.

Seladelpar and Elafibranor: The Second-Line Options for PBC After Ursodeoxycholic Acid Fails

Seladelpar and elafibranor offer new therapeutic avenues for primary biliary cholangitis patients with inadequate response to ursodeoxycholic acid.

Oral Immunotherapy: Who Finishes the Course?

Patient selection for oral immunotherapy is critical, as adherence and completion rates vary significantly based on patient characteristics and disease severity.

Personality Disorder: The Shift from Categorical to Dimensional Diagnosis

The field of personality disorder diagnosis is moving towards a dimensional model, offering a more precise understanding of patient presentations beyond traditional categories.

Off-label prescribing in borderline personality disorder: where medication helps and where it does not

Off-label prescribing of psychotropics for psychiatric inpatients with intellectual disability is common, with a survey identifying specific drug classes used for unlicensed indications.

Dialectical Behaviour Therapy: Does Brief Intervention Hold Up Long-Term?

Long-term psychological treatments are recommended for personality disorders, but brief interventions show uncertain long-term benefit for borderline personality disorder.

Psilocybin for depression: separating the hype from the clinical reality

Psilocybin shows potential in treating depression, particularly for treatment-resistant forms, but its complex administration and safety profile require careful consideration.

Treatment resistance: Why a shifting definition changes who gets care

The threshold for defining treatment resistance directly impacts patient eligibility for advanced therapies, creating disparities in access to care.

Esketamine vs. quetiapine: which augmentation strategy works for TRD?

Comparing esketamine and quetiapine augmentation for treatment-resistant depression reveals distinct efficacy and safety profiles.

OCD Diagnosis: Why Patients Wait Over a Decade for Help

Patients with obsessive-compulsive disorder face an average 11-year delay to diagnosis, often due to misidentification in primary care and mental health settings.

Why OCD demands higher SSRI doses than depression

Obsessive-compulsive disorder often requires significantly higher selective serotonin reuptake inhibitor doses compared to major depressive disorder for optimal therapeutic effect. This difference reflects distinct neurobiological underpinnings and receptor dynamics.

Phosphate binders: The hidden pill burden sabotaging CKD management

Managing hyperphosphatemia in chronic kidney disease (CKD) demands strict adherence to phosphate binders, but the sheer pill burden often undermines treatment.

Deep TMS for Treatment-Resistant OCD: Does the Benefit Last?

Deep transcranial magnetic stimulation (dTMS) offers a non-invasive option for treatment-resistant obsessive-compulsive disorder (OCD). The critical question remains regarding the long-term durability of its therapeutic effects.

Steroid-dependent pericarditis: escaping a cycle clinicians create

Recurrent pericarditis often traps patients in a cycle of corticosteroid dependence, leading to significant morbidity. Newer anti-inflammatory strategies aim to break this pattern.

Colchicine in acute pericarditis: why it remains underused

Colchicine is an established, effective therapy for acute pericarditis, reducing recurrence and improving symptom control. Despite guideline recommendations, its uptake in clinical practice remains suboptimal.

Rilonacept: Blocking IL-1 to break the cycle of recurrent pericarditis

Rilonacept targets interleukin-1, a key inflammatory cytokine, to prevent recurrent episodes of pericarditis, offering a new therapeutic approach.

Why the heart team model is essential as structural options multiply

The heart team model provides a multidisciplinary approach to complex structural heart disease, ensuring optimal patient selection and treatment strategy in an era of expanding therapeutic options.

Tricuspid intervention: when to operate on the 'forgotten valve'

Selecting patients for tricuspid valve intervention remains a complex decision, balancing symptom burden with the risks of an often-late diagnosis.

TAVI durability: How long can a transcatheter valve last in younger patients?

Transcatheter aortic valve implantation (TAVI) has expanded to lower-risk and younger patients, but long-term durability data remains a critical consideration for these populations.

Endocarditis: Why a team approach is the strongest predictor of survival

Multidisciplinary team referral for infective endocarditis is associated with a significant reduction in mortality. This integrated care model improves patient outcomes by streamlining diagnosis and management.

Sjögren's Disease: Bridging the 5-Year Diagnostic Gap to Emerging Therapies

Sjögren's disease often faces a significant diagnostic delay, leading to irreversible damage. This review highlights unmet needs, diagnostic challenges, and promising new immunoselective therapies.

Sjögren's Disease: New Therapies Target Underlying Immune Pathways

Sjögren's disease lacks approved disease-modifying therapies. Recent insights into its immunopathogenesis are driving the development of targeted treatments for this chronic autoimmune disorder.

Sjögren's Disease: Early Damage Often Present at Diagnosis

A 5-year multicentre study reveals that irreversible organ damage in Sjögren's disease frequently occurs early, with nearly half of patients showing damage at baseline. High disease activity and specific symptoms predict damage accrual across ocular, oral, and systemic domains.

Tolvaptan and ADPKD: Does slowing kidney growth preserve function?

Tolvaptan slows the increase in total kidney volume in autosomal dominant polycystic kidney disease (ADPKD), but the direct translation of this effect into preserved kidney function remains a key question for clinicians.

Why patient-reported outcomes rarely make it onto drug labels

Despite their clinical relevance, patient-reported outcomes (PROs) face significant hurdles in gaining regulatory approval for inclusion on drug labels.

Lupus Nephritis: How Low Can Steroid Doses Go?

Lower-dose steroid regimens in lupus nephritis are increasingly favored, balancing efficacy against the substantial burden of glucocorticoid toxicity.

Why PROMs are failing regulatory scrutiny, and how to fix them

Patient-reported outcome measures (PROMs) are increasingly critical for drug approval, but many fail to meet regulatory standards for validity and reliability.

Does routine symptom monitoring with PROs actually improve survival?

Routine symptom monitoring using patient-reported outcomes does not improve survival in complex chronic conditions, despite its perceived benefits for quality of life.

Real-world evidence: How regulators changed what sponsors submit

Regulatory guidance on real-world evidence has evolved, prompting sponsors to integrate diverse data sources into submissions for drug approvals and label expansions.

Why real-world evidence studies often overstate drug benefits

Real-world evidence studies can be prone to confounding by indication, where sicker patients receive different treatments, skewing observed outcomes.

When do regulators accept external control arms, and when do they not?

Regulators in Europe show varied acceptance of external control arms, with France and Germany more open than the UK, Italy, and Spain.

Managing the nocebo effect in biosimilar switches

The nocebo effect significantly impacts biosimilar adoption, driving patient and physician uncertainty despite demonstrated safety and efficacy.

Biosimilar Switching: Is the Immunogenicity Signal a Real Concern?

Biosimilar switching studies consistently show no significant efficacy or immunogenicity differences compared to reference products, despite persistent clinician concerns.

Cervical Cancer Elimination: Why Europe's Screening Registries Fall Short

Most countries lack robust screening registries needed to track the full cervical cancer elimination cascade, hindering progress toward WHO targets.

Vestibular Migraine vs. Meniere Disease: Separating Overlapping Diagnoses

Differentiating vestibular migraine from Meniere disease remains a clinical challenge, but emerging biomarkers and refined diagnostic criteria offer clearer distinctions.

Does single-dose HPV vaccination offer enough protection for a schedule change?

The shift to a single-dose HPV vaccine schedule hinges on immunogenicity data, raising questions about long-term efficacy compared to multi-dose regimens.

Do CGRP Monoclonal Antibodies Offer Relief for Vestibular Migraine Vertigo?

CGRP monoclonal antibodies, established for migraine prophylaxis, are being explored for their potential to reduce vertigo attacks in vestibular migraine, a condition often challenging to manage.

Maternal mortality disparities: What interventions actually move the numbers?

Addressing maternal mortality disparities requires targeted interventions beyond general improvements in care. Effective strategies focus on systemic changes and direct clinical support for vulnerable populations.

Why long COVID research still struggles with a case definition

Long COVID research faces significant hurdles due to the lack of a consistent case definition, hindering clinical trials and patient care.

Maternal Sepsis: Why Pregnancy Masks Critical Vital Sign Patterns

Physiological changes in pregnancy can obscure typical sepsis vital sign patterns, delaying diagnosis and increasing maternal morbidity and mortality.

Tranexamic acid in postpartum haemorrhage: how much does every minute matter?

Tranexamic acid is a critical intervention for postpartum haemorrhage, but the precise timing of administration significantly impacts its efficacy.

One-Step or Two-Step Screening: The Unresolved Debate

The long-standing disagreement over optimal screening strategies persists, with new research focusing on novel detection methods rather than resolving the core debate.

Unpacking Post-COVID Dysautonomia and POTS in General Practice

Post-COVID dysautonomia, including POTS, presents a diagnostic challenge in general practice, requiring careful assessment of symptoms and exclusion of other conditions. Early recognition is key for appropriate management strategies.

Continuous Glucose Monitoring in Pregnancy: Who Benefits and What to Target

International consensus highlights CGM and AID benefits for pregnant women with type 1 diabetes, but targets for GDM and type 2 diabetes remain undefined.

Unpacking the long-term cognitive toll of COVID-19

Cognitive deficits after COVID-19 persist in many patients, with recovery patterns varying significantly across domains and over time.

Metformin or insulin for gestational diabetes: beyond glucose control

Metformin and insulin are both effective for glycemic control in gestational diabetes, but their impact on maternal and neonatal outcomes differs.

Suzetrigine: A new mechanism for neuropathic pain, but what does it mean for practice?

Suzetrigine introduces a novel mechanism for neuropathic pain, targeting Nav1.8 channels. This approach offers a potential alternative to existing treatments.

Neuropathic pain: Do screening tools change how we manage it?

Screening tools for neuropathic pain aim to distinguish it from nociceptive pain, but their utility in altering clinical management remains a point of contention.

Why adrenaline autoinjectors are still carried less often than prescribed

Despite clear guidelines, many patients prescribed adrenaline autoinjectors for anaphylaxis risk do not consistently carry them, leaving them vulnerable.

Gabapentinoids for Sciatica: Do They Actually Work?

Gabapentinoids are widely prescribed for sciatica and radicular pain, but evidence suggests their efficacy is less robust than often assumed in clinical practice.

Biphasic Anaphylaxis: How Long Must Patients Be Observed?

Understanding the risk of biphasic anaphylaxis is critical for determining appropriate observation periods in the emergency setting.

Intranasal Epinephrine: Is a Needle-Free Option Viable for Anaphylaxis?

Intranasal epinephrine demonstrated comparable pharmacokinetics to intramuscular injection, even in patients with allergic rhinitis, suggesting a needle-free option for severe allergic reactions.

What the tominersen failure taught Huntington disease drug development

The discontinuation of tominersen in Huntington disease trials highlighted the complexities of targeting mutant huntingtin protein and the need for refined therapeutic strategies.

Managing chorea: balancing tetrabenazine, deutetrabenazine and psychiatric risk

Tetrabenazine and deutetrabenazine effectively reduce chorea in Huntington's disease, but clinicians must weigh their psychiatric adverse effects.

The hidden costs of a false penicillin allergy label

A false penicillin allergy label drives increased healthcare costs, worse clinical outcomes, and higher antimicrobial resistance rates.

AMT-130 in Huntington disease: What early gene therapy data really tell us

Early data on AMT-130 gene therapy for Huntington disease require careful interpretation, focusing on safety and target engagement rather than efficacy.

Unmasking Penicillin Allergy: A Workflow for the Non-Allergist

Many patients carry an unsubstantiated penicillin allergy label, leading to suboptimal antibiotic choices. A structured delabelling workflow, implementable by generalists, can safely remove these labels.

Rusfertide and hepcidin mimetics: a different way to control erythrocytosis

New therapeutic approaches targeting hepcidin pathways offer a novel mechanism to control erythrocytosis, moving beyond traditional phlebotomy.

Direct Oral Challenge: A Simpler Path for Low-Risk Penicillin Allergy?

Direct oral challenge offers a noninferior alternative to skin testing for low-risk penicillin allergy labels, simplifying delabeling efforts.

Haematocrit targets: Is 45% still the right threshold for phlebotomy?

The 45% haematocrit threshold for phlebotomy in polycythaemia vera is a long-standing guideline, but its evidence base warrants re-examination for optimal patient outcomes.

Early Allergen Introduction: Did Clinical Practice Really Shift?

Despite evolving guidelines recommending early allergen introduction to prevent food allergies, uptake in clinical practice has been slow and inconsistent among healthcare providers.

Why molecular response in polycythemia vera remains an elusive endpoint

A network meta-analysis of polycythemia vera treatments was not feasible due to substantial heterogeneity in study designs and outcome definitions.

Oral Immunotherapy: Who Finishes the Course?

Patient selection is critical for oral immunotherapy completion, with factors like age, baseline sensitivity, and family support influencing adherence.

PNH: Beyond Eculizumab, How Proximal Inhibition Reshaped Treatment Goals

Paroxysmal nocturnal hemoglobinuria treatment has evolved from C5 inhibition to targeting earlier complement cascade components, aiming for more complete disease control.

Omalizumab for multi-food allergy: How much protection is enough?

Omalizumab demonstrated a protective effect against accidental exposure to multiple food allergens, raising questions about the clinical threshold for meaningful protection in daily life.

When complement inhibitors fail: Recognizing breakthrough haemolysis

Breakthrough haemolysis on complement inhibitors requires prompt recognition and management to prevent severe complications in patients with complement-mediated diseases.

Oral factor B inhibition: a new path for PNH management?

Iptacopan, an oral factor B inhibitor, offers a novel approach to paroxysmal nocturnal hemoglobinuria (PNH) by targeting the alternative complement pathway.

Dialysis: Do we actually know the right phosphate target?

The optimal serum phosphate target for patients on dialysis remains a subject of ongoing debate, with current guidelines offering broad ranges.

Myelofibrosis: Why transplant timing dictates survival, not just symptoms

Early referral for allogeneic stem cell transplant in myelofibrosis patients with higher-risk disease is critical. Optimal timing balances disease progression against transplant-related mortality.

The hidden cost of phosphate binders: Why adherence crumbles under pill burden

Poor adherence to phosphate binders in chronic kidney disease is a major problem, driven by the sheer number of pills patients must take daily.

Choosing a JAK Inhibitor in Myelofibrosis: Beyond Ruxolitinib

Four JAK inhibitors manage myelofibrosis symptoms and splenomegaly, but patient-specific cytopenias dictate optimal agent selection.

Momelotinib and anaemia in myelofibrosis: a new calculus for treatment?

Momelotinib offers a distinct approach to myelofibrosis management, specifically addressing anaemia, a common and debilitating complication.

Gene therapy for thalassemia: Approval is one hurdle, access is the next

Gene therapy offers a new treatment option for thalassemia, but the complex logistics and high costs present significant barriers to patient access.

Tenapanor: A non-binder approach to phosphate control in chronic kidney disease

Tenapanor offers a novel, non-binder mechanism for reducing serum phosphate in chronic kidney disease, targeting intestinal sodium-hydrogen exchanger 3.

Iron chelation in gene therapy: When to stop, and how to monitor

Gene therapies for transfusion-dependent anemias introduce new questions about iron overload management. Clinicians must determine optimal chelation cessation and monitoring strategies.

Tolvaptan's Liver Risk: A Monitoring Burden Patients Weigh Differently

Tolvaptan's hepatotoxicity risk necessitates frequent monitoring, a burden that impacts patient adherence and quality of life differently across individuals.

CRISPR-edited cells offer durable transfusion independence in beta-thalassemia

Exagamglogene autotemcel, a CRISPR-based gene-editing therapy, provides sustained transfusion independence for patients with transfusion-dependent beta-thalassemia.

Identifying rapid progressors in ADPKD: The Mayo imaging classification in practice

The Mayo imaging classification helps identify ADPKD patients at high risk of rapid disease progression, guiding therapeutic decisions and patient stratification.

Why rosacea flushing resists standard therapy: a neurovascular disconnect

Rosacea's persistent flushing often fails to respond to conventional treatments, pointing to a deeper neurovascular dysregulation beyond simple inflammation.

Tolvaptan and ADPKD: Does slowing kidney growth preserve function?

Tolvaptan slows the increase in total kidney volume in autosomal dominant polycystic kidney disease (ADPKD), but the direct translation to preserved renal function remains a key question.

Lower-dose steroids in lupus nephritis: How far has guidance truly moved?

Guideline recommendations for lupus nephritis have shifted towards lower-dose steroid regimens, aiming to balance efficacy with reduced toxicity.

Matching rosacea therapy to dominant features: A phenotype-led approach

Treating rosacea effectively requires identifying the dominant clinical features, as a phenotype-led approach can guide targeted therapy for optimal patient outcomes.

Lupus Nephritis: When to Re-Biopsy After Induction Therapy

Re-biopsy after lupus nephritis induction therapy correlates with clinical response, but biomarker utility for guiding this decision remains limited.

Does targeting Demodex mites improve rosacea outcomes?

Topical ivermectin significantly reduced inflammatory lesions in papulopustular rosacea, suggesting a role for Demodex mite modulation in treatment.

Voclosporin and belimumab: What trials measured, and what they missed

Voclosporin and belimumab trials for lupus nephritis used different endpoints, complicating direct comparisons of their clinical efficacy.

Antihistamine-refractory urticaria: when standard care falls short

Current guidelines for chronic urticaria recommend step-up therapy for patients who do not respond to standard antihistamine doses, escalating to higher doses or adding biologics.

Why recurrent vertigo often goes undiagnosed, despite clear patterns

Recurrent spontaneous vertigo, a common and debilitating condition, frequently eludes accurate diagnosis, leading to prolonged patient suffering.

Chronic Urticaria: The Diagnostic Tests That Rarely Help

Many tests for chronic urticaria offer little diagnostic value, often leading to unnecessary patient anxiety and cost. A focused history and physical examination remain paramount.

Remibrutinib: A New BTK Inhibitor for Chronic Urticaria Beyond Omalizumab

A novel BTK inhibitor, remibrutinib, offers a new therapeutic option for chronic spontaneous urticaria, moving beyond existing treatments like omalizumab.

Alopecia Areata: What happens when patients stop treatment?

Patients with alopecia areata often experience relapse or worsening of hair loss upon discontinuation of systemic therapies, highlighting the chronic nature of the disease and the need for sustained treatment.

JAK Inhibitors for Alopecia: What Monitoring Do Patients Actually Need?

JAK inhibitors offer effective systemic treatment for severe alopecia areata, but require careful pre-treatment screening and ongoing monitoring for adverse events.

JAK Inhibitors in Alopecia Areata: Which One Delivers the Most Hair Regrowth?

Baricitinib, ritlecitinib, and deuruxolitinib show varying short-term efficacy for scalp hair regrowth in severe alopecia areata, with no head-to-head trials.

Vitiligo: More Than Skin Deep, It's an Autoimmune Assault

Vitiligo is increasingly recognized as a systemic autoimmune disease, not merely a cosmetic concern. This shift in understanding opens new avenues for targeted therapies beyond topical treatments.

Vitiligo: Why managing expectations for facial vs. hand repigmentation matters

Vitiligo treatment response varies significantly by body site, with facial lesions repigmenting faster and more completely than those on the hands.

Topical ruxolitinib for vitiligo: how much repigmentation, and how long does it hold?

Topical ruxolitinib offers a non-steroidal option for vitiligo, inducing repigmentation in some patients. Understanding the extent and durability of this response is key for clinical practice.

Crystal Arthritis: The ICU Fever You Keep Missing

Crystal arthritis, often overlooked in critically ill patients, frequently presents as unexplained fever in the intensive care unit. Early recognition is vital for appropriate management.

When Joint Pain Strikes: Distinguishing Gout, Pseudogout, and Septic Arthritis

Rapid differentiation of acute monoarthritis is critical, as misdiagnosis can lead to severe joint destruction or systemic sepsis.

Calcium Pyrophosphate Deposition Disease: What the 2023 Criteria Enable

New classification criteria for calcium pyrophosphate deposition disease (CPPD) offer a more precise diagnostic framework, distinguishing it from other arthropathies.

Obstetric antiphospholipid syndrome: why treatment evidence runs out

Obstetric antiphospholipid syndrome poses significant risks to pregnancy, but the evidence for optimal treatment beyond standard anticoagulation is limited.

Antiphospholipid Antibody Testing: When to Trust the Results

Interpreting antiphospholipid antibody test results requires careful consideration of timing, thresholds, and repeat testing to avoid misdiagnosis and inappropriate treatment.

Why triple-positive antiphospholipid syndrome defies direct oral anticoagulants

Direct oral anticoagulants (DOACs) have consistently failed to prevent recurrent thrombotic events in patients with triple-positive antiphospholipid syndrome (APS). This subgroup requires careful consideration of traditional anticoagulation.

Statin-associated myopathy: rare, real, and reversible?

Statin-associated immune-mediated necrotising myopathy is a rare but distinct adverse event, requiring prompt diagnosis and specific immunomodulatory treatment.

Myositis-Specific Autoantibodies: Predicting Prognosis and Guiding Screening

Myositis-specific autoantibodies offer prognostic insights and direct screening strategies in dermatomyositis, influencing disease course and malignancy risk.

Intravenous Immunoglobulin for Dermatomyositis: What the Approval Evidence Shows

Intravenous immunoglobulin (IVIg) has received approval for dermatomyositis, with evidence showing its role in managing this rare autoimmune condition.

Autologous Stem Cell Transplant in Scleroderma: Who Justifies the Risk?

Autologous stem cell transplantation offers a potential disease course modification for diffuse cutaneous scleroderma patients with early, mild organ involvement, but not those with severe or end-stage disease.

Pulmonary Hypertension in Scleroderma: Who Needs Screening, and How Often?

Systemic sclerosis patients face high mortality from pulmonary hypertension, but identifying those at risk and optimal screening methods remain challenging.

Refining Endometrial Cancer Prognosis: When POLE Mutations Truly Matter

A large genomic analysis refines endometrial cancer molecular classification, showing that only specific POLE variants confer a favorable prognosis and dMMR status offers class-level immunotherapy eligibility.

Immune Checkpoint Inhibitor Myocarditis: A Rare, High-Mortality Risk

Immune checkpoint inhibitors (ICIs) can cause severe immune-related adverse events, including cardiotoxicity. Myocarditis is a rare but highly fatal complication, driven by complex immune dysregulation. Early detection and targeted management are crucial.

Durvalumab Plus Chemotherapy: A New First-Line Option for Advanced Biliary Tract Cancer?

Adding durvalumab to gemcitabine and cisplatin significantly improved overall survival and progression-free survival in advanced biliary tract cancer, offering a potential new first-line treatment. The safety profile was comparable to chemotherapy alone.

Cervical Cancer Elimination: Why Income Isn't the Only Barrier

A new model suggests structural factors beyond income, such as health system capacity and education, are critical for cervical cancer elimination. Comprehensive policy engagement is needed to meet WHO targets globally.

Navigating PSMA-RLT for Prostate Cancer: What Clinicians Need to Know Now

PSMA-targeted radioligand therapy (RLT) is a recognized treatment for metastatic castration-resistant prostate cancer (mCRPC). This guide summarizes current evidence, practical considerations, and toxicity monitoring for integrating PSMA-RLT into prostate cancer management.

Antibody-Drug Conjugates: The Evolving Role in Breast Cancer Management

Antibody-drug conjugates (ADCs) are transforming breast cancer treatment by precisely delivering cytotoxic agents. This review highlights their molecular mechanisms, clinical evolution, and impact across HER2-positive, HER2-low, and triple-negative subtypes.

CAR-T Neurotoxicity: Beyond ICANS and the Transplant Center

CAR-T cell therapy can cause diverse neurotoxicities, including delayed non-ICANS syndromes. Recognition outside specialized centers is crucial as CAR-T expands to new indications and patient populations.

Dostarlimab Plus Chemotherapy Extends Progression-Free Survival in Advanced Endometrial Cancer

Adding dostarlimab to carboplatin-paclitaxel chemotherapy significantly improved progression-free survival in patients with primary advanced or recurrent endometrial cancer, particularly in those with mismatch repair-deficient tumors. This Phase 3 trial highlights the potential of immunotherapy in this setting.

Managing Trastuzumab Deruxtecan: Dosing and Adverse Event Insights

A pooled analysis of DESTINY trials characterizes the safety profile of trastuzumab deruxtecan across two doses. It highlights common gastrointestinal and hematologic adverse events, alongside interstitial lung disease, to inform proactive management.

Zolbetuximab: A New First-Line Option for CLDN18.2-Positive Gastric Cancer?

Two Phase 3 trials, SPOTLIGHT and GLOW, demonstrate that zolbetuximab combined with chemotherapy significantly improves progression-free and overall survival in CLDN18.2-positive, HER2-negative advanced gastric or GEJ adenocarcinoma.

CAR T-Cell Therapy and Secondary T-Cell Malignancies: What the Data Reveal

Recent reports of secondary T-cell malignancies following CAR T-cell therapy have prompted investigation. The FDA is evaluating these cases, emphasizing the need for careful patient monitoring and further research into potential mechanisms.

When to use 177Lu-PSMA-617 in metastatic prostate cancer: before or after taxanes?

New data clarifies the optimal sequencing of lutetium-177 PSMA-617 (177Lu-PSMA-617) in metastatic castration-resistant prostate cancer, showing benefit in both pre- and post-taxane settings. This radioligand therapy significantly prolongs progression-free survival.

Pembrolizumab Improves Overall Survival in Locally Advanced Cervical Cancer

Adding pembrolizumab to chemoradiotherapy significantly improved overall survival in patients with high-risk, locally advanced cervical cancer. This combination therapy reduced the risk of death by 33% compared to placebo.

Perioperative Immunotherapy for Resectable NSCLC: A Comparative Review Protocol

A new Cochrane review protocol outlines a network meta-analysis to compare various perioperative immunotherapy strategies for resectable non-small cell lung cancer (NSCLC). The aim is to establish a hierarchy of effectiveness and safety for different agents and administration timings.

KRAS Mutations Signal Poorer Outcomes in Biliary Tract Cancers

A Belgian cohort study reveals distinct molecular profiles across biliary tract cancer subtypes. KRAS mutations, found in 20.4% of cases, were significantly linked to worse overall survival, highlighting the need for routine molecular profiling.

HER2 Heterogeneity: Why Single-Block Testing May Miss Gastric Cancer Treatment Targets

Intratumoral HER2 heterogeneity is common in gynecologic cancers, with single-block assessment potentially underestimating expression. This highlights challenges in gastric cancer biomarker testing, where spatial and temporal heterogeneity can impact treatment decisions.

Trastuzumab Deruxtecan Reshapes HER2-Low Metastatic Breast Cancer Treatment

Trastuzumab deruxtecan significantly improved progression-free and overall survival in HER2-low metastatic breast cancer, challenging previous treatment paradigms. This benefit extended across various patient subgroups, including those with different endocrine resistance profiles and disease burdens.

Targeted Therapies Extend Survival in Advanced Cholangiocarcinoma

New data from two studies highlight the efficacy of targeted therapies, pemigatinib and ivosidenib, for advanced cholangiocarcinoma with specific genomic alterations. These treatments offer improved outcomes for patients with FGFR2 fusions or IDH1 mutations.

Immunotherapy Reshapes First-Line Treatment for Advanced Endometrial Cancer

Adding pembrolizumab to chemotherapy significantly improved progression-free survival in advanced or recurrent endometrial cancer, regardless of mismatch repair status. These findings support updated first-line treatment guidelines.

Radioligand Therapy: Is Capacity, Not Efficacy, Limiting Patient Access?

Radioligand therapy (RLT) offers targeted cancer treatment, with two agents approved for neuroendocrine tumors and prostate cancer. Despite growing evidence and trials, global access disparities and infrastructure limitations pose significant challenges to its broader implementation.

Two-Year Checkpoint Inhibitor Therapy: Is It Enough for Advanced NSCLC?

A systematic review suggests that discontinuing immune checkpoint inhibitor therapy after two years in advanced non-small cell lung cancer may offer comparable survival to continuous treatment, potentially reducing long-term immune-related adverse events.

Cilta-cel Extends Overall Survival in Lenalidomide-Refractory Multiple Myeloma

A recent Phase 3 trial, CARTITUDE-4, demonstrates that ciltacabtagene autoleucel (cilta-cel) significantly improves overall survival in patients with lenalidomide-refractory multiple myeloma. This updated analysis supports earlier use of cilta-cel in the treatment pathway.

Adding Pembrolizumab to Chemotherapy Extends Survival in Advanced Cervical Cancer

A Phase 3 trial demonstrates that adding pembrolizumab to standard chemotherapy, with or without bevacizumab, significantly improves progression-free and overall survival for patients with persistent, recurrent, or metastatic cervical cancer.

FLOT Regimen Extends Survival in Resectable Gastric Adenocarcinoma

A phase 2/3 trial found that perioperative FLOT chemotherapy improved overall survival compared to ECF/ECX in patients with locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma. The docetaxel-based triplet regimen demonstrated a median overall survival of 50 months.

Denosumab: A New Role in Joint Protection for Osteoporosis?

Denosumab, a standard osteoporosis treatment, may offer additional benefits in protecting joint integrity in adults with osteoporosis.

Multi-Antigen T-Cells Show Early Promise in Pediatric Brain Tumors

A Phase 1 trial of multi-antigen-targeting T cells in pediatric CNS tumors met safety and feasibility endpoints, showing preliminary efficacy signals.

Temferon: A New Gene Therapy Strategy for Glioblastoma

A phase 1 trial of Temferon, a tumor-targeted interferon-α gene therapy, showed safety and tolerability in newly diagnosed glioblastoma patients.

Nurse-led education: a simple fix for diabetic foot treatment delays?

A nurse-led health education intervention may reduce treatment delays in patients with diabetic high-risk foot, improving timely access to care.

Hyperkalemia risk: Empagliflozin, finerenone, or both?

A secondary analysis of the CONFIDENCE trial explored hyperkalemia risk with empagliflozin, finerenone, or combination therapy in patients with chronic kidney disease.

KRAS vaccine with dual checkpoint blockade shows early promise in pancreatic cancer

A mutant KRAS vaccine combined with ipilimumab and nivolumab generated significant T cell responses in resected pancreatic adenocarcinoma patients.

Bone Biopsy Offers No Edge Over Ulcer Swab in Diabetic Foot Osteomyelitis

Bone biopsy-guided antibacterial therapy did not improve remission rates compared to ulcer bed biopsy in diabetic foot osteomyelitis.

Mazdutide's Dual Agonism: A New Path for Type 2 Diabetes in Chinese Adults?

Mazdutide, a dual GLP-1 and glucagon receptor agonist, significantly reduced HbA1c and body weight in Chinese adults with type 2 diabetes compared to placebo.

Adjunctive Embolization for Chronic Subdural Hematoma: Does it Reduce Recurrence?

Adjunctive middle meningeal artery embolization did not reduce chronic subdural hematoma recurrence after surgical drainage in the EMMA-Can trial.

Why Primary Care Burnout Is a Systemic Problem, Not a Personal Failing

Primary care physicians face escalating demands and systemic pressures that contribute to burnout, impacting patient care and physician well-being. Addressing these issues requires structural changes, not just individual resilience strategies.

Why do benralizumab patients still suffer asthma attacks?

Asthma exacerbations in patients on benralizumab are largely non-eosinophilic, indicating a need for therapies targeting alternative inflammatory pathways.

Smouldering myeloma: What Lauren Laverne's diagnosis means for patients

Smouldering multiple myeloma is a precursor condition to active multiple myeloma, characterised by abnormal plasma cells without end-organ damage. Its diagnosis prompts careful monitoring, as progression to active disease is not inevitable but carries significant risk.

Italy's COVID-19 Victims Association: Why Their Lobbying Success Matters for Future Pandemic Accountability

Six years after the initial COVID-19 outbreak, an Italian victims' association has achieved significant lobbying success, pushing for greater accountability over pandemic mismanagement.

Why humans don't catch cancer from each other, unlike some animals

Transmissible cancers, where malignant cells spread between individuals, are rare but exist in several animal species. Humans are largely protected from this phenomenon due to robust immune surveillance and genetic diversity.

Strictly Come Dancing: The hidden injury risks behind the sparkle

Behind the glamour of ballroom dancing, participants face significant musculoskeletal injury risks, ranging from sprains to fractures.

Air filters fail to curb respiratory infections, challenging common assumptions

A landmark study indicates that portable air filters do not reduce the incidence of infectious respiratory diseases in community settings.

Your kitchen sponge is a microbial time bomb, and you can't tell

Kitchen sponges harbor diverse bacterial communities, including potentially harmful pathogens, which persist despite common cleaning methods.

Vegan and Vegetarian Diets: What They Tell Us About Eating Disorder Risk

Dietary restrictions, including vegan and vegetarian patterns, are frequently observed in individuals with eating disorders. These choices can complicate diagnosis and treatment, often masking underlying psychopathology.

Beyond cardio: Strength training is women's essential preventive health

Strength training offers substantial benefits for women across all life stages, from bone density to metabolic health and functional independence.

Conflict Zones: How War Fuels Infectious Disease Outbreaks and Hides Them

Armed conflicts create ideal conditions for infectious disease outbreaks, disrupting public health infrastructure and making detection difficult.

The Unexpected Upside: How Boredom Can Sharpen Focus and Drive Innovation

Boredom, often seen as a negative state, can actually foster creativity, improve problem-solving, and enhance self-awareness, offering unexpected cognitive benefits.

Heatwaves: A Silent Killer for Europe's Homeless Population

Extreme heat exacerbates chronic conditions and creates unique challenges for homeless individuals, leading to increased morbidity and mortality.

Ten simple ways to reduce your patients' home pollutant exposure

Reducing indoor air pollution is achievable with practical steps, from ventilation to material choices. Clinicians can advise patients on these actionable changes.

Can social care ever truly be fixed? Experts weigh in on the latest policy promises

New government pledges aim to overhaul social care, but experts question whether systemic issues can be resolved without fundamental shifts in funding and integration.

Hundreds died from undiagnosed TB in England, raising diagnostic questions

Hundreds of people in England died before receiving a tuberculosis diagnosis, highlighting persistent challenges in early detection and public health surveillance.

Decades of financial stress leave an indelible mark on brain health

An 80-year longitudinal study reveals that persistent financial worries from childhood can lead to measurable cognitive decline in later life.

Why for-profit firms in social care erode clinical standards

Andy Burnham's call to remove for-profit firms from social care reflects a growing concern that profit motives compromise patient outcomes and system resilience.

Infrared Workouts: Six Things Clinicians Should Know

Infrared workouts leverage heat to induce physiological responses, but their specific benefits beyond traditional exercise remain a subject of ongoing discussion.

Can you build strength without lifting to absolute failure?

Submaximal resistance training can elicit significant strength gains, challenging the long-held belief that pushing to muscle failure is essential for hypertrophy and power.

Early PFAS exposure linked to childhood gut inflammation

Early life exposure to per- and polyfluoroalkyl substances (PFAS) correlates with increased risk of intestinal inflammation in children.

Orzeyful: A New Path to Wakefulness in Narcolepsy?

Orzeyful, an orexin receptor 2 agonist, improves wakefulness and reduces cataplexy in narcolepsy, addressing core symptoms of the chronic disorder.

Clesrovimab: Can a monoclonal antibody protect infants from severe RSV?

Clesrovimab, a monoclonal antibody, is being investigated for its potential to protect infants entering their second RSV season from severe respiratory syncytial virus infection. This approach aims to provide passive immunity where active vaccination is not yet fully established.

Naked on Rounds: Why Doctors' Stress Dreams Reflect Clinical Reality

Physicians frequently report stress dreams featuring common clinical scenarios, reflecting the high-stakes environment and pervasive anxieties of medical practice.

Cognitive Care in Sickle Cell Disease: New Standards Target Overlooked Burden

New standards aim to integrate cognitive care into sickle cell disease management, addressing a significant, often overlooked, burden on patients.

Ebola vaccine could stem Congo outbreak, WHO advisors say

WHO advisors have indicated that a licensed Ebola vaccine could be deployed to help control the ongoing outbreak in the Democratic Republic of Congo.

Rheumatology's 'Difficult-to-Treat' Patients Need More Than Just Drugs

A new perspective on 'difficult-to-treat' rheumatology patients highlights the need for comprehensive, multidisciplinary care beyond pathology-driven interventions.

Do animal study metrics predict human trial success?

Replication success metrics, commonly used in reproducibility studies, often fail to predict animal-to-human translation success, particularly with increasing heterogeneity.

Mathematical models: The next frontier for optimising mosquito net distribution

Mathematical models can optimise malaria control by tailoring mosquito net distribution to regional transmission dynamics and behavioral characteristics. This approach aims to improve resource allocation in endemic areas.

Noninvasive bioelectric therapy for dry AMD enters pivotal trial

A noninvasive bioelectric therapy for dry age-related macular degeneration (AMD) has begun a pivotal study. The device aims to address the unmet need for effective treatments in this patient population.

Breast Density Laws: More Screening, But Is It Better Screening?

Laws mandating breast density notification have increased supplemental screening, but evidence for improved outcomes remains limited.

Do Herbal Supplements Offer Real Metabolic Benefits in MASLD?

Some herbal supplements demonstrate potential metabolic benefits for patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), influencing liver enzymes and lipid profiles.

Vapes for Smoking Cessation: A Pragmatic Shift in Addiction Treatment?

Experts are increasingly endorsing e-cigarettes as a viable tool for smoking cessation, acknowledging their role in harm reduction despite ongoing debates about long-term safety.

Why traditional sleep aids miss the gut-sleep link after hydrogen supplementation?

Emerging research explores the intricate link between gut microbiota composition and sleep quality, particularly after hydrogen supplementation.

Menopause and obesity: a dangerous metabolic synergy for GPs to watch

Menopause often exacerbates obesity, increasing the risk of metabolic and cardiovascular comorbidities. Early intervention is critical to mitigate long-term health consequences.

Medicare's APP pay parity proposal: Physician concerns laid bare

Physicians voiced significant concerns over a 2019 executive order proposing Medicare pay parity and supervision elimination for advanced practice providers.

Four EU Nations Elevate Family Medicine to a Specialty. Will Others Follow?

Four European Union member states have formally recognized family medicine as a distinct medical specialty, a move that could reshape primary care training and delivery across the continent.

Does medical volunteering truly sharpen clinical acumen?

Medical volunteering offers exposure to diverse pathologies and resource-constrained settings, but its direct impact on clinical skill development remains a subject of debate among medical educators.

Lyme disease: Why early diagnosis is often missed

Lyme disease, a tick-borne illness, presents in distinct stages with varied clinical manifestations, necessitating accurate diagnosis and timely treatment to prevent chronic complications.

Dry eye: Why current treatments fall short, and what's next

A novel molecule derived from extremophile bacteria shows promise in improving symptoms and signs of dry eye disease, addressing a significant unmet need.

Oral and kidney health: a neglected link in global disease burden

Poor oral health contributes significantly to the global burden of disease, with a clear but under-recognised link to kidney disease outcomes.

Can a bacterial lysate curb recurrent respiratory infections?

Broncho-Vaxom, a bacterial lysate, appears to reduce the frequency and severity of recurrent respiratory tract infections in susceptible individuals.

Cushing Syndrome: A Silent Threat in Neuroendocrine Neoplasms

Cushing syndrome is associated with a poor prognosis in patients with neuroendocrine neoplasms, complicating management and outcomes.

Hospitalists' Brutal Shifts: Can New Strategies Offer Real Relief?

Hospitalists face intense work demands and burnout. New approaches to scheduling, team-based care, and personal resilience may offer some mitigation.

Adipose Tissue: Beyond Quantity, A Driver of Cardiometabolic Risk?

Adipose tissue distribution and phenotype, not just total mass, shape cardiovascular risk through endocrine, paracrine, and neural pathways.

Weight loss: The 'metabolic advantage' is a myth. Here's why

Despite evolving dietary trends, the fundamental principle of caloric deficit remains central to effective weight management and metabolic health.

Sleep Coaching May Ease Glucose Control in Type 1 Diabetes

Structured sleep coaching can improve sleep quality and may contribute to better glycemic management for some adults living with type 1 diabetes.

Nerve Stimulation's Lasting Impact on Pediatric Bladder Control

Children treated with sacral neuromodulation for bladder dysfunction may experience sustained relief years after therapy cessation. This suggests a potential for long-term benefit beyond active treatment.

Does Vitamin D3 Supplementation Improve Colorectal Cancer Survival?

High-dose vitamin D3 supplementation has been explored for its potential role in improving survival outcomes for patients with colorectal cancer.

Stop guessing TNBC outcomes. Start with sTILs

Thymectomy does not increase long-term mortality or cancer risk at 10 years, according to a new analysis of patients with triple-negative breast cancer.

Metformin and Exercise: A Complicated Partnership in Type 2 Diabetes

The long-held assumption that metformin and exercise work synergistically in type 2 diabetes is being re-evaluated, with emerging perspectives suggesting potential interference.

Coronary Artery Calcium Scoring: Refining Statin Decisions Beyond Traditional Risk

Coronary artery calcium (CAC) scoring offers a more precise assessment of cardiovascular risk, potentially reclassifying patients for statin therapy.

First-in-Human Gene Editing Trial: What Went Wrong?

Early gene editing trials face inherent risks, with initial human studies often revealing unforeseen complexities in delivery and off-target effects.

Beyond the Scale: Reframing GLP-1 Success for Patients

GLP-1 receptor agonists offer benefits beyond weight reduction, including improvements in cardiometabolic health and quality of life.

Off-label testosterone use: a cardiovascular gamble for men?

Off-label testosterone therapy for men without clear hypogonadism may increase cardiovascular event risk, prompting a re-evaluation of prescribing practices.

UV light exposure still not classified as US workplace hazard

Despite clear evidence linking UV light to skin cancers in animals, US regulatory bodies have yet to classify it as a workplace hazard, leaving human workers unprotected.

Maternal RSV shot vs. infant antibody: What parents really want

Pregnant women and parents show a clear preference for maternal RSV vaccination over infant monoclonal antibody administration for RSV prevention.

AI calorie trackers miss a third of intake, undermining weight goals

AI-powered photo-based calorie tracking tools consistently underestimate caloric intake by an average of 33%, a significant margin that can hinder weight management efforts.

Missing neuropathic corneal pain means prolonged patient suffering

Neuropathic corneal pain presents a significant challenge, often persisting despite conventional treatments and requiring a multi-modal approach.

Ocular surface disease: The overlooked comorbidity complicating glaucoma management

Ocular surface disease is an essential, often missed, component of glaucoma care, impacting treatment adherence and quality of life.

Why do children with sinusitis keep getting unnecessary antibiotics?

Children with upper respiratory tract infections are 1.3 times more likely to receive antibiotics than adults, despite viral origins.

Can targeting tau slow cognitive decline in Alzheimer's disease?

Diranersen, an investigational antisense oligonucleotide, reduced tau levels and showed a corresponding slowdown in cognitive decline.

Closing the gap: a 5-step plan for psoriasis and metabolic disease

A new framework outlines a five-step action plan to improve screening and management of metabolic comorbidities in patients with psoriasis.

Avoiding three risk factors extends life without dementia

Reducing three modifiable risk factors significantly extends the period of life lived without dementia, a new analysis indicates.

Dupilumab improves inflammation in eosinophilic gastritis, but what about symptoms?

Dupilumab significantly reduced eosinophil counts in patients with eosinophilic gastritis, addressing a key inflammatory driver of the disease.

A New Explanation for Excessive Sweating Points to Nerve Dysfunction

New research suggests that excessive sweating, or hyperhidrosis, may stem from a specific dysfunction in the sympathetic nervous system, rather than overactive sweat glands.

Prostatectomy Leakage: The Long Road to Recovery

Urinary leakage after prostate surgery often improves significantly over 12 months, a critical period for patient recovery and quality of life.

What really killed thousands in the English Sweating Sickness?

The English Sweating Sickness, a series of devastating epidemics, remains an enigma, with historical accounts pointing to a rapid, fatal course.

Does Breastfeeding Protect Against Early Childhood Caries?

The relationship between breastfeeding practices and the development of early childhood caries remains a complex and often misunderstood area.

Social care reform: Why funding isn't the real problem

Meaningful social care reform hinges entirely on addressing workforce shortages and improving conditions, not just funding. Without a stable, skilled workforce, increased investment alone will not deliver better care.

Why compelling health claims often fail patients

Misleading health claims often exploit cognitive biases and emotional responses, making them appear credible. Clinicians must guide patients to reliable sources.

The 'wellness' industry is coming for your patients' pets

The pet wellness industry is expanding rapidly, mirroring human trends with unproven supplements and alternative therapies. Clinicians should be aware of the potential for harm and the lack of regulatory oversight.

Hypoxia: Is your patient's vascular disease adapting for the worse?

Hypoxia significantly alters the cistrome in human umbilical vein endothelial cells, impacting gene regulation critical for vascular function and disease progression.

Bladder-sphincter dyssynergia: A brainstem switch just flipped our understanding

Estrogen receptor 1-expressing neurons in the pontine micturition center precisely coordinate bladder contraction and urethral sphincter relaxation for urination.

Early Parkinson's: Targeting LRRK2 could preserve synaptic function

LRRK2, a protein linked to Parkinson's disease, regulates synaptic function by modulating actin cytoskeletal dynamics, a process important for early synaptic alterations.

Endometrial repair: Why ALDH HI cells are the missing piece

Endometrial cells with high ALDH activity function as long-lived progenitors, critical for uterine development and regeneration, according to new research.

Phage hunting: Why our current methods miss the best targets

A novel geomapping strategy combined with a portable device identified ecological hotspots for phage hunting, yielding 36 new phages against extremely resistant ESKAPE pathogens.

CXCL13 and PAH lung cancer: What a recent correction means for you

A correction has been issued for a paper on the chemokine CXCL13 in lung cancers linked to polycyclic aromatic hydrocarbons pollution, clarifying author affiliations.

The real reason TB remains the top infectious killer

Tuberculosis remains the leading global cause of death from a single infectious agent, with incidence and mortality targets for 2035 at risk.

SARS-CoV-2: Why ACE2 isn't the whole story for infection

Heparan sulfate clusters, not ACE2, mediate SARS-CoV-2 cell attachment and endocytosis, with ACE2 functioning downstream for viral genome expression.

The real reason AYA cancer patients miss fertility preservation

Adolescent and young adult women with cancer face significant disparities in access to fertility preservation services across Europe. These variations impact long-term quality of life and reproductive autonomy.

Cannabinoid hyperemesis: Why cannabis users self-medicate with hot showers

Cannabinoid hyperemesis syndrome presents as cyclic vomiting in chronic cannabis users, a diagnosis often delayed due to its mimicry of other conditions.

Tirzepatide's cardiovascular benefits extend beyond weight loss

Tirzepatide, a dual GIP and GLP-1 receptor agonist, demonstrates significant cardiovascular risk reduction in real-world patient populations.

Why conventional CV risk scores fail Native American patients

Existing cardiovascular risk prediction models often underperform in Native American populations, highlighting a critical unmet need for tailored assessments. Improved models are essential for effective prevention strategies.

mRNA flu shots: What changes beyond COVID-19?

The FDA approved mFlusiva, the first mRNA-based influenza vaccine, marking a significant step for mRNA technology beyond COVID-19.

Apalutamide + ADT: Is intensified blockade the answer for prostate cancer?

Perioperative apalutamide with androgen deprivation therapy (ADT) reduced metastasis and death in high-risk localized prostate cancer, showing a 4.7% absolute benefit at 5 years.

Urgency incontinence: The implant option for non-refractory patients

The FDA cleared the Revi Extend implant for urgency urinary incontinence, offering a novel neuromodulation system for nonrefractory patients.

Why are seemingly mild gastroenteritis cases turning severe now?

A widespread Salmonella outbreak linked to fresh jalapeño peppers has sickened hundreds of individuals across multiple US states, prompting public health warnings.

Why do some veterans face higher ALS risk than others?

Military service branch and rank correlate with amyotrophic lateral sclerosis incidence among US veterans, with Air Force and officers showing higher risk.

Sotatercept: PAH’s systemic secret weapon?

Sotatercept improves exercise tolerance in pulmonary arterial hypertension by modulating central, hematologic, and peripheral mechanisms, according to new research.

Why do some tissues resist oncogenesis, even with mutations?

Mechanical interactions between oncogenic and wild-type cells dictate tumor initiation and progression in a tissue-specific manner, independent of mutation.

Late thrombectomy for stroke: When 6 hours isn't the whole story

Mechanical thrombectomy may offer clinical benefits for acute ischemic stroke patients with large infarct cores, even when performed beyond the standard early treatment window.

Alternative cancer clinics: More harm than hope for your patients

Unconventional cancer clinics offer unproven therapies, often preying on patient desperation. These treatments lack scientific validation and can pose significant risks.

The 'mental shortcuts' paradox: How heuristics lead to diagnostic errors

Clinicians often rely on heuristics, or mental shortcuts, which can lead to diagnostic and management errors when patient presentations deviate from classic textbook examples.

Patients find AI portal messages as empathetic as human ones. Really?

Patients generally find AI-generated messages in patient portals acceptable, often perceiving them as equally trustworthy and empathetic as human-written responses.

Forget big diet changes: Small 'single swaps' may be your patients' best bet

Michael Greger, MD, advocates for 'single swaps' in dietary choices, emphasizing that small, consistent changes can lead to substantial health improvements.

Retatrutide: Early access vs. unknown risks for your patients?

Expanded access for retatrutide is drawing mixed reactions from clinicians, who are balancing patient need with the limited data available outside of formal trials.

Rethinking weighted vests: Are they really building bone density?

Weighted vests are often promoted for bone health, but the evidence for their efficacy in increasing bone mineral density is not as straightforward as some claim.

Behavioral interventions may lower obesity-related cancer risk

Behavioral interventions promoting weight loss can mitigate metabolic dysfunction and reduce the risk of several obesity-related cancers.

Your AI diet plans for hypertension may be doing more harm than good

Large language models consistently fail to generate adequate, evidence-based dietary recommendations for patients with hypertension.

Nicotine pouches: Why FDA clearance doesn't mean widespread access

The FDA authorized four on! nicotine pouch products, marking a significant regulatory step for newer tobacco products. Retail audits reveal varying availability across US sites and demographic correlations.

Beyond depression: Early pregnancy emotional health is more complex

Emotional disorders in early pregnancy are prevalent and significantly impact maternal and child health, necessitating effective interventions.

Abortion not linked with mental health medication use

A new analysis found no association between abortion and subsequent use of mental health medication, challenging common assumptions.

Robotic surgery isn't replacing surgeons. But it is changing anesthesia

Robotic platforms enhance surgical precision and patient outcomes, but human expertise remains central to complex procedures, particularly in cardiac and gynecologic surgery.

Epilepsy advocacy: Why Hollywood's voice matters for patient care

Actor Greg Grunberg highlights critical issues in epilepsy advocacy, focusing on stigma, treatment access, and the need for greater public understanding.

Creatine supplementation in hemodialysis: A futile exercise?

Intradialytic creatine supplementation in hemodialysis patients showed feasibility and tolerability but lacked evidence of meaningful clinical improvement in a pilot study.

Decentralized Trials: Expanding Access, But Facing Digital Hurdles

Decentralized clinical trials increase patient access and diversity, but operational, regulatory, and technological challenges limit widespread adoption.