CARDIOLOGY

As heart failure cases rise, clearer use of patient-reported outcomes (PROs) is key. This article addresses current gaps and proposes better PRO integration in research and care.

Heart Failure Trials Need Better Use of PRO Measures

As global heart failure cases rise, focus is shifting beyond mortality to how patients feel and function. However, interpreting PROs is challenging due to inconsistent timing, unclear clinical relevance of score changes, and flawed analytic methods. This article explores these issues using the Kansas City Cardiomyopathy Questionnaire, aiming to standardize PRO use in clinical, research, and regulatory settings.

PULMONOLOGY

Higher CALLY index levels are associated with a lower risk of incident COPD, highlighting the role of immuno-nutritional status.

CALLY Index and Risk of Incident COPD: Findings From UK Biobank

A prospective UK Biobank study involving 292,945 participants found that a higher C-reactive protein–albumin–lymphocyte (CALLY) index was associated with a lower risk of developing chronic obstructive pulmonary disease (COPD). Over 13.6 years of follow-up, each unit increase in ln-CALLY was associated with a 17% reduction in COPD risk. The association followed an L-shaped pattern, highlighting the potential role of immuno-nutritional status in respiratory health.

Real-world study finds BGF triple therapy improves COPD symptoms and quality of life while reducing exacerbation rates.

Real-World Effectiveness of Budesonide/Glycopyrronium/Formoterol in COPD

A prospective, multicentre observational study involving 571 patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) in Germany and the UK found that budesonide/glycopyrronium/formoterol (BGF) fixed-dose combination improved respiratory health status and quality of life. At 3 months, COPD Assessment Test scores improved by 3.28 points, with 58.2% of patients achieving the minimum clinically important difference. Annualised exacerbation rates decreased by 40% over 12 months, supporting the effectiveness of BGF in routine clinical practice.

GLP-1RAs were associated with lower risks of sepsis, pneumonia, and mortality in patients with COPD and type 2 diabetes.

GLP-1 Receptor Agonists and Sepsis Risk in Patients With COPD and Type 2 Diabetes

A population-based cohort study using the TriNetX Global Network found that glucagon-like peptide-1 receptor agonists (GLP-1RAs) were associated with lower risks of sepsis, pneumonia, and all-cause mortality compared with DPP-4 inhibitors in patients with chronic obstructive pulmonary disease (COPD) and type 2 diabetes. Among 40,148 propensity-matched patients, GLP-1RA use was associated with a 14.8% lower risk of sepsis, a 27.1% lower risk of pneumonia, and a 34.4% lower risk of all-cause mortality at one year. Further randomised trials are needed to confirm these findings.

GENERAL MEDICINE

Obesity may contribute to persistent liver inflammation and metabolic dysfunction following SARS-CoV-2 infection, according to a mouse study.

Obesity and Persistent Hepatic Immunometabolic Changes Following SARS-CoV-2 Infection

A preclinical study in lean and diet-induced obese mice found that obesity was associated with persistent liver injury and immunometabolic disturbances following SARS-CoV-2 infection. Obese mice showed increased hepatic lipid accumulation, cellular apoptosis, and altered metabolic function, alongside sustained inflammatory changes in liver macrophages, hepatocytes, and endothelial cells. These findings suggest that obesity may impair the restoration of hepatic immune and metabolic homeostasis after COVID-19, potentially contributing to post-acute liver complications.

Cardiovascular disease is associated with faster lung function decline and increased COPD progression risk in individuals with PRISm.

Cardiovascular Disease and Risk of COPD Progression in Patients With PRISm

A retrospective cohort study involving 521 individuals with preserved ratio impaired spirometry (PRISm) found that baseline cardiovascular disease (CVD) was associated with greater respiratory complications and an increased risk of progression to chronic obstructive pulmonary disease (COPD). Participants with CVD had a 2.48-fold higher risk of frequent exacerbations, accelerated declines in lung function, and a 63% higher risk of developing COPD. These findings suggest that cardiovascular assessment may help improve risk stratification in individuals with PRISm.

NEUROLOGY

A systematic review highlights the outcomes of microaxial pumps for temporary mechanical circulatory support in children.

Microaxial Pump Use and Outcomes in Pediatric Mechanical Circulatory Support

A systematic review of 44 studies involving 100 pediatric patients evaluated the use of microaxial pumps for temporary mechanical circulatory support. Cardiomyopathy (29%), heart allograft rejection (26%), and myocarditis (21%) were the most common indications. Cardiac recovery and heart transplantation enabled discontinuation of support in 42% and 31% of patients, respectively. Overall survival at a median follow-up of 119 days was 84%. Mortality was higher among patients receiving combined ECPella support than those receiving microaxial pumps alone, highlighting the importance of patient selection.

Indian study finds that single-inhaler triple therapy improves lung function, asthma control, and quality of life in adults with uncontrolled asthma.

Budesonide/Glycopyrrolate/Formoterol Triple Therapy in Uncontrolled Asthma

A multicentre, prospective observational study across five centres in India found that single-inhaler triple therapy (SITT) combining budesonide, glycopyrrolate, and formoterol improved lung function, asthma control, and quality of life in adults with uncontrolled asthma. Among 231 patients analysed, mean Asthma Control Test (ACT) scores increased from 14.29 to 18.49 over 12 weeks, indicating a shift towards partially controlled asthma. High medication adherence was reported, with no exacerbations or adverse events observed during follow-up.

Immunotherapy achieves disease control in patients with cutaneous squamous cell carcinoma and perineural spread, with some experiencing nerve recovery.

Immunotherapy Outcomes in Cutaneous Squamous Cell Carcinoma With Perineural Spread

A systematic review of 23 studies involving 150 patients found that immunotherapy achieved disease control in 87.3% of patients with head and neck cutaneous squamous cell carcinoma (cSCC) involving perineural spread (PNS). Cemiplimab was the most commonly used treatment, followed by pembrolizumab. Complete and partial responses were reported in 38.7% and 42.0% of patients, respectively. Functional cranial nerve recovery was observed in 40.6% of patients with evaluable outcomes, highlighting the potential of immunotherapy in managing this challenging condition.

Response-adapted surgery after neoadjuvant chemotherapy shows favourable surgical outcomes in oral cavity cancer.

Response-Adapted Surgery Following Neoadjuvant Chemotherapy in Oral Cancer

A retrospective study involving 129 patients with oral cavity squamous cell carcinoma evaluated response-adapted surgery following neoadjuvant chemotherapy (NACT). Compared with conventional surgery, the response-adapted approach was associated with fewer positive surgical margins (1.4% vs 3.4%) and lower local recurrence (7.0% vs 12.1%). Two-year disease-free survival was numerically higher with response-adapted surgery (67.8% vs 56.6%), although the difference was not statistically significant. The findings suggest that response-adapted resection may be a feasible surgical strategy, warranting further prospective evaluation.

GYNAECOLOGY - IVF

A review of 96 studies highlights limited causal evidence for reported hearing loss risk factors among NICU graduates.

Risk Factors and Evidence Gaps for Hearing Loss in NICU Graduates: A Scoping Review

A scoping review of 96 studies identified 141 factors potentially associated with hearing loss (HL) among neonatal intensive care unit (NICU) graduates, grouped into six domains and 32 categories. Birthweight, hyperbilirubinemia, Apgar score, sepsis, and sex were the most frequently investigated factors. However, evidence supporting a causal relationship was identified in only four studies (4.2%), highlighting substantial gaps in current research. The findings emphasise the need for well-designed prospective studies to identify credible prevention targets and improve hearing health outcomes in high-risk newborns.

Clopidogrel monotherapy was associated with fewer ischemic events than aspirin in high-risk patients after PCI, with similar bleeding rates.

Clopidogrel vs Aspirin After PCI: Benefits in High-Risk Patients

A post hoc analysis of the SMART-CHOICE 3 trial involving 5,506 patients found that clopidogrel monotherapy was associated with a lower risk of major adverse cardiac and cerebrovascular events than aspirin in patients at higher atherothrombotic risk following PCI. The benefit was not observed in lower-risk patients, while bleeding rates remained similar between treatments.

DERMATOLOGY

A review of 26 trials finds limited evidence for combined laser treatments for acne and postsurgical scars.

Combined Laser Treatments for Acne and Surgical Scars: Evidence Review

A network meta-analysis of 26 randomized trials involving 771 participants evaluated laser monotherapy and combined-laser approaches for atrophic acne and postsurgical scars. Although one trial found greater scar improvement with pulsed-dye laser plus nonablative fractional laser than with fractional laser alone, evidence for combined protocols remains sparse. Researchers highlight the need for larger, high-quality comparative trials.

BAHCC1 promotes vascular smooth muscle cell changes and neointimal hyperplasia, highlighting a potential therapeutic target.

BAHCC1: An Epigenetic Driver of Neointimal Hyperplasia

Researchers have identified BAHCC1 as an epigenetic regulator that promotes vascular smooth muscle cell dedifferentiation and neointimal hyperplasia, a process contributing to atherosclerosis and restenosis. Experimental models showed that disrupting BAHCC1 activity reduced pathological vascular remodelling by restoring the expression of LMO7, a gene that suppresses neointimal growth. The findings highlight BAHCC1 as a potential therapeutic target for vascular disease.

UROLOGY

A study links neurogenic urinary incontinence to greater persistence with Botox therapy, while socioeconomic factors show no independent association.

Factors Influencing Botox Treatment Continuation in Urinary Incontinence

A retrospective study of 723 adults receiving onabotulinumtoxinA (Botox) for urgency urinary incontinence found that only 40% continued treatment with repeat injections within two years. Patients with non-neurogenic urinary incontinence had nearly twice the odds of discontinuing therapy compared with those with neurogenic disease. Socioeconomic factors were not independently associated with treatment discontinuation after adjustment for diagnosis.

DDR1-mediated THBS1 signalling may connect arterial stiffness with accelerated atherosclerosis in chronic kidney disease.

DDR1–THBS1 Pathway Links Arterial Stiffness to CKD-Related Atherosclerosis

A study has identified a potential mechanism linking arterial stiffness to accelerated atherosclerosis in chronic kidney disease (CKD). Researchers found that DDR1 activation in vascular smooth muscle cells increased THBS1 secretion, promoting endothelial cell activity and vascular inflammation. In experimental models, disrupting DDR1 signalling reduced arterial stiffening and atherosclerotic burden. Plasma THBS1 levels also increased with CKD severity, highlighting a potential biomarker and therapeutic pathway.

Improving Patient-Reporte...

Improving Patient-Reported Outcomes in Heart Failure Management