ENDO-DIABETOLOGY

Nursery rhymes represent the simplest and most innocent form of performance art. 'Humpty-Dumpty' is a popular character of a nursery rhyme. This character denotes a humanized egg. In medicine, the term 'Humpty-Dumpty syndrome' has been used in many specialities. In neurology, “Humpty-Dumpty” syndrome is used to denote prosopagnosia and in rehabilitation medicine and psychiatry...

Humpty-Dumpty Syndrome in Medicine: Understanding its Neurological and Rehabilitation Implications

UROLOGY

COUB was independently linked to more severe nocturia in men and women in a Japanese community health survey.

COUB Linked to Severe Nocturia in Men and Women

A 2023 Japan Community Health Survey analysis found that co-existent overactive and underactive bladder (COUB) was independently associated with ≥2 nighttime voids in both men and women. COUB prevalence was 6.1% in men and 2.6% in women, identifying it as a distinct, severe nocturia phenotype.

Proximal ATOMS implantation improved long-term continence and satisfaction in men with post-prostatectomy incontinence.

Proximal ATOMS Technique Improves Continence After Prostatectomy

A retrospective study of 131 men with severe post-prostatectomy incontinence found that proximal ATOMS implantation achieved higher complete continence (64.6% vs 38.1%), greater satisfaction and fewer urgency symptoms than the classic technique, with similar complication and explantation rates.

Sacral neuromodulation improved symptoms and quality of life in children with refractory lower urinary tract dysfunction.

Sacral Neuromodulation Benefits Children With Refractory LUTD

A multicenter study of 205 children with refractory lower urinary tract dysfunction found that 79% reported partial or complete symptom improvement after sacral neuromodulation. Quality of life and bowel-bladder dysfunction scores also improved, while 21% experienced device complications and 13% had devices removed after symptom resolution or treatment success.

U.S. payer policies for sacral nerve stimulation vary in indications, requirements, and supporting evidence.

U.S. Payer Policies for Sacral Nerve Stimulation Vary

An analysis of 11 major U.S. payers found that all covered core urinary indications for sacral nerve stimulation, but 63.6% excluded neurologic disease. Conservative therapy failure was universally required, while evidence supporting coverage criteria varied widely, highlighting inconsistencies and transparency gaps in prior authorization policies.

PEDIATRICS

Physiotherapy is central to PCD care, but limited evidence highlights the need for standardized guidelines and stronger trials.

Physiotherapy and Airway Clearance in Primary Ciliary Dyskinesia

Physiotherapy, especially airway clearance therapy, remains a cornerstone of primary ciliary dyskinesia (PCD) management, helping compensate for impaired mucociliary clearance and reduce respiratory complications. Current evidence shows no clear superiority among techniques such as PEP, ACBT, IPV or HFCWO. Early, age-adapted therapy and adherence support are recommended, while stronger trials and international guidelines are needed.

NEUROLOGY

Reduced occipital alpha EEG synchronisation may serve as an objective marker of daytime sleepiness in Parkinson’s disease.

EEG Marker for Daytime Sleepiness in Parkinson’s Disease

A study of 62 adults with Parkinson’s disease found that reduced low-alpha (8–10 Hz) EEG phase synchronisation in the occipital cortex was the strongest predictor of greater daytime sleepiness. The findings suggest disrupted arousal networks may contribute to sleepiness in PD and indicate that resting-state EEG could potentially serve as an objective marker for symptom severity.

DERMATOLOGY

Review finds minoxidil and hair transplantation may improve temporal triangular alopecia, but evidence remains limited.

Temporal Triangular Alopecia: Minoxidil and Hair Transplant Evidence

A systematic review of nine studies involving 23 patients found that both hair transplantation and topical minoxidil may improve the appearance of temporal triangular alopecia, a rare non-scarring hair-loss condition. Transplantation showed durable cosmetic benefits in reported cases, while minoxidil offered a non-invasive option. However, evidence remains limited to small case reports and a case series.

Meta-analysis finds high pyeloplasty success across drainage strategies, with differing risks of leakage and infection.

JJ vs External Stenting After Pediatric Pyeloplasty: Meta-Analysis

A network meta-analysis of 26 studies involving 3,298 children with PUJ obstruction found high surgical success regardless of drainage strategy after Anderson–Hynes pyeloplasty. JJ and external stents reduced major urine leakage or urinoma compared with stentless repair, while JJ stents increased UTI/pyelonephritis risk. Overall, drainage choice should be individualized.

RHEUMATOLOGY

A new 12-domain VEXAS-DAI aims to quantify inflammatory activity and track disease progression in VEXAS syndrome.

VEXAS-DAI: New Tool to Measure Disease Activity in VEXAS Syndrome

An international expert panel has developed the VEXAS Disease Activity Index (VEXAS-DAI) to systematically measure inflammatory activity across organ systems in patients with VEXAS syndrome. Developed through four Delphi rounds and tested using 158 clinical cases, the index covers 12 domains and provides a 0–40 score. Prospective validation in clinical trials is ongoing.

Sleep disturbances, depression and anxiety remain common after mild TBI, highlighting the need for screening and comprehensive care.

Sleep Disorders and Mood Problems After Mild Traumatic Brain Injury

A retrospective study of 46 adults with mild traumatic brain injury found persistent sleep and psychological difficulties at least 6 months after injury. Measures of daytime sleepiness, insomnia, sleep quality, depression and anxiety were significantly associated with neurobehavioral symptoms. The findings support routine screening and comprehensive management of sleep disorders after mTBI.

Study finds bladder washing cytology adds no diagnostic benefit to cystoscopy and increases costs in neuro-urological evaluation.

Bladder Washing Cytology in Neuro-Urological Disorders: Study

A prospective study of 581 patients with neurological disorders found that bladder washing cytology (BWC) did not improve tumour detection when added to urethro-cystoscopy (UC). All eight clinically relevant histological findings were identified by UC. Adding BWC increased costs by 22.8% without improving diagnostic yield, suggesting routine BWC may be unnecessary during initial neuro-urological evaluation.

GYNAECOLOGY - IVF

Threatened preterm labor was associated with persistent fetal cardiac remodeling and subtle right-ventricular dysfunction.

Threatened Preterm Labor and Fetal Cardiac Remodeling

A prospective cohort study found that fetuses exposed to threatened preterm labor without intra-amniotic infection or inflammation showed early cardiac remodeling and subtle right-ventricular diastolic dysfunction. Among 32 exposed fetuses, these changes persisted 4 weeks later despite normalization of systolic function, suggesting threatened PTL may have longer-lasting effects on fetal cardiovascular development.

Fetal exome sequencing can identify mild or manageable genetic conditions and reduce uncertainty during prenatal counseling.

Fetal Exome Sequencing Improves Prenatal Prognostic Counseling

A retrospective analysis of 1,692 fetuses undergoing exome sequencing found molecular diagnoses in 291 cases. Five fetuses had genetic findings associated with comparatively favorable outcomes, including isolated polydactyly, X-linked ichthyosis, situs inversus and transient antenatal Bartter syndrome. The findings show that exome sequencing can provide reassurance and improve prenatal counseling.

GLP-1 withdrawal can cause weight regain and metabolic relapse, highlighting the need for sustainable long-term obesity care.

What Comes After GLP-1 Success? Rethinking Long-Term Obesity Care

Incretin-based therapies are delivering major weight-loss and glycemic benefits, but discontinuation can trigger rapid weight regain and worsening hyperglycemia. New evidence highlights the need for individualized, long-term treatment strategies that address durability, affordability, tolerability, adherence, and patient preferences rather than viewing therapeutic success as the endpoint.

Postnatal debriefing is valued after unexpected birth interventions, but gaps remain in documentation and future pregnancy counseling.

Postnatal Debriefing After Unexpected Birth Interventions

A prospective Dublin maternity hospital survey found that 72.1% of women received documented postnatal debriefing after unexpected intrapartum interventions in 2024. Most valued early discussions with clinicians, reporting strong understanding and satisfaction, but gaps remained in documentation, written information and counseling on future pregnancy risks.

Endocrinology and “Humpty...

Endocrinology and “Humpty-Dumpty”