RHEUMATOLOGY

PHARMACOLOGY

Early TNFi use in axial spondyloarthritis was not associated with reduced chronic opioid use risk, highlighting the complexity of pain management in biologic-treated patients.

TNFi Therapy and Opioid Use in Axial Spondyloarthritis

This retrospective cohort study evaluated whether early tumor necrosis factor inhibitor (TNFi) therapy reduces chronic opioid use among adults with axial spondyloarthritis (axSpA) using MarketScan data. Early TNFi initiation was not linked to lower risk of long-term opioid use, suggesting that timing of biologic therapy may not independently reduce opioid dependence in axSpA patients.

Genetically predicted oral microbial taxa were associated with allergic rhinitis risk in an East Asian Mendelian randomization study.

Oral Microbiome May Influence Allergic Rhinitis Risk

A bidirectional Mendelian randomization study using East Asian genetic data identified multiple oral microbial taxa potentially associated with allergic rhinitis (AR) risk. Genetically predicted levels of 16 tongue dorsum and 22 salivary taxa were associated with AR, with several associations supported by Bayesian MR analysis. The findings suggest a potential role of the oral microbiome in AR susceptibility.

PULMONOLOGY

One in four children with asthma exacerbations did not receive guideline-concordant treatment in general emergency departments.

Asthma Care Gaps Identified in General Emergency Departments

A retrospective study of 319 children with moderate to severe asthma exacerbations treated at general emergency departments found that only 74% received guideline-concordant care, including systemic corticosteroids, inhaled albuterol, and ipratropium. Pediatric readiness scores were not associated with guideline-concordant treatment, suggesting that general pediatric preparedness may not fully capture disease-specific emergency care capabilities.

Hybrid physiotherapy and digital resources were acceptable for children with asthma and breathing pattern disorders.

Hybrid Physiotherapy Supports Asthma Care in Children With Breathing Disorders

A prospective mixed-methods study of 25 children and adolescents with asthma and breathing pattern disorders found that co-designed digital resources and hybrid physiotherapy services were highly acceptable and feasible. All participants completed the 12-week program without intervention-related adverse events. However, technical challenges, digital inclusion, and higher virtual-session non-attendance remain important implementation considerations.

DENTISTRY

Higher platelet doses in PRF/PRP may improve new bone formation during sinus lift procedures, but evidence remains preliminary.

Higher PRF/PRP Dose May Improve Bone Formation After Sinus Lift

A systematic review of 25 studies evaluated the osteogenic effects of platelet concentrates (PRF/PRP) combined with non-autogenous graft materials during sinus lift procedures. Studies reporting positive outcomes used higher platelet doses than negative studies. In eight RCTs, high-dose preparations showed significantly greater new bone formation, although the proposed dose is not a clinically validated threshold.

NEUROLOGY

Low-dose cyclobenzaprine did not significantly reduce sleep bruxism activity or bite force in a randomized clinical trial.

Cyclobenzaprine Shows Limited Benefit for Sleep Bruxism

A randomized, double-blind, placebo-controlled crossover trial found that 5 mg of cyclobenzaprine taken for three nights did not significantly reduce sleep bruxism-related masticatory muscle activity, maximum voluntary bite force, or bruxism awareness. The treatment was generally well tolerated, although participants reported significantly more tolerable dry mouth upon awakening.

GYNAECOLOGY - IVF

FETO survivors with CDH showed improving multisystem morbidity, with respiratory and gastrointestinal complications most common.

FETO Outcomes in Infants With Congenital Diaphragmatic Hernia

A systematic review of 14 studies involving 395 infants found that survivors of fetal endoscopic tracheal occlusion (FETO) for congenital diaphragmatic hernia experienced substantial but improving multisystem morbidity. Respiratory complications were most common, while growth failure improved with catch-up growth by 2 years. Gastroesophageal reflux affected 25–50% and hernia recurrence 21–43%, with neurodevelopmental outcomes generally reassuring.

PEDIATRICS

Medication reviews identified hidden nonadherence and drug-related problems in people with cystic fibrosis.

Medication Reviews Improve Adherence Assessment in Cystic Fibrosis

A cross-sectional study of 43 children and adults with cystic fibrosis found adherence was higher for CFTR modulators than supportive therapies. Adherence to CFTR modulators was 91.7% by pharmacy data versus 56.3% for supportive therapies. Medication reviews identified four nonadherent patients missed by other methods and 51 drug-related problems, highlighting their clinical value.

Salivary metabolic fingerprinting distinguished COPD from controls and correlated with airflow obstruction and disease severity.

Salivary Metabolomics May Help Detect and Assess COPD Severity

An exploratory study of 47 people with COPD and 48 healthy controls found that salivary metabolic profiles could distinguish COPD from controls with 73% sensitivity and 72% specificity. Six metabolites correlated with airflow obstruction and COPD severity, while altered pathways included lipid processing, nucleotide metabolism, pterin biosynthesis and melatonin.

OPHTHALMOLOGY

Intracranial aneurysms may cause visual field defects and cranial nerve III palsy, highlighting the need for ophthalmologic assessment.

Intracranial Aneurysms Linked to Visual Field Defects and III Palsy

A retrospective study of 142 patients with intracranial aneurysms found that ophthalmological abnormalities extended beyond eye-movement problems. Cranial nerve III palsy occurred in 50% of internal carotid-posterior communicating artery aneurysms, while visual field defects were seen across both anterior and posterior circulation aneurysms, including 21% of basilar artery cases.

Lenticule surface regularity was associated with contrast sensitivity after KLEx, while visual outcomes remained excellent at 6 months.

Lenticule Regularity Linked to Visual Quality After KLEx

A study of 92 patients undergoing keratorefractive lenticule extraction (KLEx) with the VisuMax 800 found excellent visual outcomes at 6 months, with all eyes achieving 20/25 or better uncorrected vision. Contrast sensitivity improved significantly over time, while lenticule surface regularity was associated with contrast sensitivity during postoperative recovery.

TNF-α and anti-CD20 therapies showed distinct rhinosinusitis patterns, including fungal and recurrent bacterial infections.

TNF-α and Anti-CD20 Therapies Linked to Rhinosinusitis Patterns

A scoping review of 33 studies identified two distinct rhinosinusitis patterns linked to immunomodulatory therapies. TNF-α inhibitors were associated with new-onset or severe rhinosinusitis, including opportunistic and invasive fungal infections, while anti-CD20 therapies were linked to recurrent bacterial infections and secondary hypogammaglobulinemia. Immunoglobulin replacement reduced infection burden in several studies.

UA Doppler classification alone poorly predicted adverse outcomes in sFGR, but combined models improved prediction with AUC >0.9.

UA Doppler Classification and Outcomes in Selective Fetal Growth Restriction

A retrospective study of 107 monochorionic diamniotic pregnancies with selective fetal growth restriction (sFGR) found that UA Doppler-based classification alone had limited ability to predict adverse outcomes (AUC 0.615). However, combining severity classification with early diagnosis, fetal weight discordance and severe growth restriction improved prediction, achieving AUCs >0.9.

FAMILY HEALTH

Physiology-guided complete revascularization reduced cardiovascular events and safety complications after STEMI with multivessel disease.

Physiology-Guided Revascularization Improves STEMI Outcomes

An international randomized trial of 1,823 patients with STEMI and multivessel disease found that physiology-guided complete revascularization reduced the risk of death, MI, stroke/TIA or ischemia-driven revascularization versus angiography-guided treatment (8.9% vs 13.7%; HR 0.62). Safety events were also lower with physiology-guided treatment (4.6% vs 7.1%).

Routine CT coronary angiography did not reduce MI or cardiac death versus standard care after MI was ruled out.

Routine CT Coronary Angiography Does Not Reduce Cardiac Events

A multicenter UK trial of 3,170 patients with suspected acute coronary syndrome but no confirmed MI found that routine outpatient CT coronary angiography did not reduce subsequent MI or cardiac death compared with standard care. After 3 years, events occurred in 7.1% with CT-guided care versus 7.3% with standard care (HR 0.95; P=0.71).

Clopidogrel alone was noninferior to extended DAPT but reduced bleeding and increased ischemic events after PCI.

Clopidogrel Monotherapy vs Extended DAPT After Drug-Eluting Stents

The A-CLOSE trial of 3,203 high-ischemic-risk patients 12 months after drug-eluting stent implantation found clopidogrel monotherapy was noninferior to extended DAPT for net adverse clinical events at 24 months (5.0% vs 5.1%). Clopidogrel alone reduced major bleeding (1.8% vs 4.1%) but increased ischemic events (3.7% vs 1.6%).

Early TNFi Use and Risk o...

Early TNFi Use and Risk of Chronic Opioid Use in Axial Spondyloarthritis Patients