CARDIOLOGY

ImP from gut microbes promotes heart disease by impairing vascular repair and insulin signaling, new study finds.

Imidazole Propionate Impairs Vascular Repair, Fuels Heart Disease

New research reveals that the gut microbial metabolite imidazole propionate (ImP) is linked to coronary artery disease by impairing endothelial cell repair and promoting inflammation. Human and animal studies show ImP worsens atherosclerosis by disrupting insulin signaling. Targeting ImP metabolism could offer a novel approach to treating cardiovascular disease.

DERMATOLOGY

Individualized surgery and superficial radiotherapy achieved an 88.1% response rate in 42 patients with sternal keloids.

Sternal Keloid Treatment: Surgery and Radiotherapy Outcomes

A retrospective study of 42 patients with sternal keloids found an 88.1% response rate with individualized surgery followed by superficial radiotherapy and adjunctive scar treatments. At 12 months, scar assessment scores improved across all treatment groups, while recurrence occurred in 11.9% of patients. Radiation dermatitis was reported in three patients and resolved with symptomatic management.

DNA aptamers and alginate–agarose hydrogels show promise for fibrosis treatment, but clinical validation remains limited.

DNA Aptamers and Hydrogels for Keloid and Fibrosis Treatment

A systematic review of 16 studies explored DNA aptamers and alginate–agarose hydrogels as emerging strategies for managing fibrosis, including keloids and hypertrophic scars. Aptamers target profibrotic signalling pathways such as TGF-β and IL-6, while hydrogels support local drug retention and controlled release. However, limited clinical evidence and few integrated approaches highlight the need for further research.

OPHTHALMOLOGY

Paul Glaucoma Implant shows comparable 12-month outcomes to Ahmed and Baerveldt devices, but evidence remains limited.

Paul Glaucoma Implant vs Ahmed and Baerveldt Devices

A Bayesian network meta-analysis of five comparative studies involving 238 patients found that the Paul Glaucoma Implant (PGI) achieved broadly comparable intraocular pressure and glaucoma medication reductions to the Ahmed Glaucoma Valve and Baerveldt Glaucoma Implant over 12 months. However, evidence certainty was low to very low, highlighting the need for larger randomised trials and longer follow-up.

ENDO-DIABETOLOGY

Front-of-pack warning labels reduce sugar consumption, but their effects on socioeconomic inequalities remain inconsistent.

Front-of-Pack Food Labels and Sugar Consumption Inequality

A systematic review of 10 studies found that front-of-pack food labels, particularly warning labels, reduced sugar consumption at the population level. However, their impact on socioeconomic inequalities was inconsistent, with studies reporting greater benefits among both higher- and lower-income groups. Poor overall study quality highlights the need for robust longitudinal research to assess equitable outcomes.

GYNAECOLOGY - IVF

A study of 10,009 IVF pregnancies links early ultrasound findings with viability and identifies a potential miscarriage threshold.

Early Ultrasound Findings and Miscarriage Risk in IVF Pregnancies

A multicenter study of 10,009 IVF pregnancies found significant differences in early crown–rump length (CRL) measurements between pregnancies that remained viable and those that ended in miscarriage. An empty gestational sac at 47 days or later after embryo transfer showed 100% positive predictive value and specificity for miscarriage in the study cohort. External validation is needed before clinical application.

Zumba improves cardiorespiratory fitness and reduces body fat in inactive women, although BMI changes are not significant.

Zumba Benefits for Fitness and Body Fat in Inactive Women

A systematic review and meta-analysis of seven randomized controlled trials found that Zumba significantly improved cardiorespiratory fitness and reduced body fat percentage in physically inactive women. Waist circumference also improved in three reports, while changes in body mass index were not statistically significant. Further research is needed to establish optimal exercise duration and long-term benefits.

Weight loss strategies differently affect gut-derived metabolites, with distinct changes after non-surgical interventions and bariatric surgery.

Weight Loss and Gut Microbiota Metabolites in Obesity

A systematic review and meta-analysis of 67 studies found that weight loss interventions have different effects on gut microbiota-derived metabolites in people with overweight or obesity. Non-surgical interventions reduced trimethylamine N-oxide (TMAO), while bariatric surgery reduced lipopolysaccharides (LPS) but increased TMAO and secondary bile acids. These findings highlight the complexity of gut microbiota–host interactions.

A meta-analysis finds PAP increases middle ear pressure and may improve eardrum retraction and hearing in selected patients.

Positive Airway Pressure and Ear Health: Middle Ear Pressure and Hearing Outcomes

A systematic review and meta-analysis of nine studies found that positive airway pressure (PAP) therapy increases middle ear pressure in a dose-dependent manner. At 10 cm H₂O, the pooled mean pressure increase was 51.4 daPa. In patients with Eustachian tube dysfunction and eardrum retraction, continuous PAP use was associated with improved eardrum morphology and a mean hearing-threshold improvement of 7.3 dB HL. Further prospective studies are needed to confirm clinical benefits and guide postoperative care.

NEUROLOGY

An international Delphi study proposes standards for defining and assessing cerebral no-reflow after stroke thrombectomy.

Cerebral No-Reflow After Stroke Thrombectomy: Expert Consensus 2026

An international Delphi study involving 27 experts developed a consensus framework for defining and assessing cerebral no-reflow after endovascular thrombectomy for stroke. Experts agreed that the phenomenon involves successful large-vessel recanalization but impaired microvascular reperfusion. The panel favoured cerebral blood flow and/or volume measurements and assessment within six hours after recanalization. Further validation and standardized quantitative thresholds are needed to improve consistency in clinical research.

PULMONOLOGY

A CHARLS study links coexisting COPD and widened pulse pressure to higher cardiovascular risk in older adults, requiring further validation.

COPD and Widened Pulse Pressure Linked to Cardiovascular Risk in Older Adults

A study of 4,183 adults aged 60 years and older in the CHARLS cohort found that coexisting COPD and widened pulse pressure (≥60 mmHg) was associated with an 86% higher risk of incident cardiovascular disease compared with neither condition. The association was primarily driven by heart disease, while no clear association was observed with stroke. The combined phenotype was also linked to higher all-cause mortality, although the difference versus COPD alone was uncertain. Further validation is needed.

Global COPD-associated heart failure cases exceeded 3.61 million in 2021, with projections indicating further increases through 2050.

Global COPD-Associated Heart Failure Burden: Trends and Projections to 2050

An analysis of Global Burden of Disease Study 2021 data found more than 3.61 million cases of COPD-associated heart failure worldwide in 2021, representing a 1.4-fold increase since 1990. The burden varied by sex, age and region, with East Asia reporting the highest regional burden and China the highest national case count. Projections suggest age-standardized prevalence and disability rates will continue rising through 2050, with slightly greater increases among females.

Dexmedetomidine was associated with lower odds of stroke-heart syndrome in critically ill ischemic stroke patients.

Dexmedetomidine and Stroke-Heart Syndrome After Ischemic Stroke

A retrospective study of 953 mechanically ventilated patients with ischemic stroke found that dexmedetomidine use within 72 hours of ICU admission was associated with 39% lower odds of stroke-heart syndrome. The association varied with cumulative dose, treatment duration, and antiplatelet therapy. Prospective studies are needed to confirm these findings.

Embryo reduction in triplet pregnancies prolonged gestation but did not lower maternal obstetric complications.

Embryo Reduction in Triplet Pregnancies: Maternal Outcomes

A Spanish study of 120 trichorionic triamniotic triplet pregnancies found that elective embryo reduction was associated with later delivery, with median gestational age increasing from 33.1 weeks to 36.2–36.6 weeks. However, it did not reduce maternal complications such as preeclampsia, gestational diabetes, or intrahepatic cholestasis, highlighting the need for individualized, non-directive counseling.

A three-level framework highlights how patient partnerships may improve hidradenitis suppurativa care and research.

Hidradenitis Suppurativa: A Three-Level Patient Partnership Framework

A narrative review proposes a three-level framework for patient partnerships in hidradenitis suppurativa (HS), spanning individual care, patient communities, and research collaboration. Strategies such as shared decision-making, teach-back communication, and online peer networks may improve treatment adherence, patient satisfaction, and the relevance of research, supporting more patient-centred care.

A machine learning model predicts mortality in critically ill COPD and sepsis patients, outperforming SOFA in internal testing.

AI Model Predicts Mortality in COPD and Sepsis Patients

A machine learning study involving 4,900 critically ill patients with COPD and sepsis developed a naive Bayes model to predict in-hospital mortality. The model outperformed the SOFA score in internal testing, achieving an AUC of 0.743 versus 0.696, but performance declined to 0.681 during external validation. Prospective multicentre validation is needed before routine clinical use.

Imidazole Propionate Impa...

Imidazole Propionate Impairs Vascular Repair, Fuels Heart Disease