CRITICAL CARE

The coronavirus disease 2019 pandemic continues to affect millions worldwide. Given the rapidly growing evidence base, we implemented a living guideline model to provide guidance on the management of patients with severe or critical coronavirus disease 2019 in the ICU. The Surviving Sepsis Campaign Coronavirus Disease 2019 panel has expanded to include 43 experts from 14 countries; all panel members completed an electronic conflict-of-interest disclosure form...

Critical Care Management of Severe Coronavirus Disease 2019: Expert Guidance from Surviving Sepsis Campaign Panel

RHEUMATOLOGY

Severe microvascular damage in systemic sclerosis is associated with bilateral carotid plaques, while age and blood pressure remain key predictors.

Systemic Sclerosis: Microvascular Damage and Carotid Plaques

A cross-sectional study of 165 patients with systemic sclerosis found carotid plaques in 46.7% of participants. Severe nailfold videocapillaroscopy abnormalities, including late scleroderma patterns, avascular areas and reduced capillary density, were associated with bilateral carotid plaques. Age and systolic blood pressure remained key predictors of carotid atherosclerosis.

DENTISTRY

Study links mild and severe periodontitis with autoimmune thyroiditis and identifies shared oral microbiome features.

Periodontitis and Autoimmune Thyroiditis: Oral Microbiome Links

An analysis of 1,346 US adults from NHANES 2009–2012 found that mild and severe periodontitis were associated with higher odds of autoimmune thyroiditis, with adjusted odds ratios of 2.15 and 2.77, respectively. Fusobacterium was identified as a shared oral microbiome genus. Longitudinal studies are needed to assess causality.

Study identifies oral microbiome differences and caries-associated factors in adults with allergic rhinitis and asthma.

Allergic Rhinitis, Asthma and Oral Microbiome–Caries Associations

A cross-sectional study of 89 participants found that adults with allergic rhinitis or asthma had greater plaque microbial diversity than controls. Among allergic participants, regular dental check-ups were associated with lower caries scores. Corynebacterium showed an inverse association with DMFT, while Actinomyces was positively associated with DMFS.

DERMATOLOGY

Clinical trials show that a soft peeling serum improves skin tone, texture, hydration, elasticity and wrinkles.

Soft Peeling Serum Improves Skin Aging Signs in Clinical Trials

Two clinical trials involving 156 Chinese women found that a soft peeling serum improved skin tone, texture, hydration, elasticity and wrinkles over 12 weeks. Benefits varied by age group, with younger women showing stronger improvements in tone and texture, while older women experienced greater improvements in elasticity and crow’s feet. No adverse events were reported.

A small study suggests Subderma-Complex may extend BTX-A effects and reduce reinjection frequency, requiring further validation.

Topical Serum May Prolong Botulinum Toxin A Effects

A study involving 15 participants found that daily application of a Subderma-Complex formulation after BTX-A treatment increased the mean reinjection interval by 65.2%, from 13.5 to 22.3 weeks. Wrinkle severity and skin quality also improved. However, the small sample size and absence of a control group limit the findings’ generalizability.

Review explores mechanism-based, multimodal strategies for managing melasma and post-inflammatory hyperpigmentation.

Hyperpigmentation Management: Mechanisms, Treatments and Emerging Strategies

A narrative review examines the molecular mechanisms of melanogenesis and current approaches to hyperpigmentation management. It emphasizes rigorous photoprotection, trigger control, topical agents and carefully selected procedures. Emerging strategies include human-tyrosinase-specific screening, targeted delivery, standardized imaging and phenotype-informed treatment, particularly for darker skin phototypes.

Systematic review evaluates treatment strategies, drug withdrawal, corticosteroid efficacy and outcomes in interstitial granulomatous dermatitis.

Interstitial Granulomatous Dermatitis: Treatment Strategies and Clinical Outcomes

A systematic review evaluates therapeutic strategies for interstitial granulomatous dermatitis (IGD), analysing treatment effectiveness, disease resolution and recurrence. The review included 108 articles involving 182 patients and highlighted autoimmune associations, drug-induced cases and malignancy-related presentations. Drug withdrawal resulted in complete or partial resolution in 95.9% of evaluable patients. Topical and systemic corticosteroids remained key treatment options, while immunomodulatory and biologic therapies demonstrated potential in refractory disease.

NEUROLOGY

Study compares estimated cardiorespiratory fitness and cognitive trajectories in Chinese and U.S. adults, highlighting cross-national differences.

Cardiorespiratory Fitness and Cognitive Decline: China–U.S. Comparison

A comparative study investigates the relationship between estimated cardiorespiratory fitness (eCRF) and cognitive trajectories among middle-aged and older adults in China and the United States. Using data from 3,458 participants in CHARLS and 6,905 in HRS, researchers identified three cognitive trajectories in both cohorts. Higher eCRF was associated with increased odds of moderate and low cognitive trajectories in the Chinese cohort, while it was associated with lower odds of the moderate trajectory in the U.S. cohort. The findings highlight potential differences in measurement, physical activity patterns and chronic disease burden, emphasizing the need for cautious interpretation and context-specific validation.

CARDIOLOGY

AGENT IDE trial analysis evaluates drug-coated balloon outcomes for coronary in-stent restenosis in patients with and without chronic kidney disease.

Drug-Coated Balloons in In-Stent Restenosis: Impact of CKD on Outcomes

A post hoc analysis of the AGENT IDE trial evaluated the efficacy and safety of drug-coated balloons (DCB) compared with conventional balloon angioplasty in patients with coronary in-stent restenosis, with and without chronic kidney disease (CKD). Among patients with CKD, DCB treatment resulted in a 2-year target lesion failure rate of 23.6%, compared with 30.0% with balloon angioplasty. The treatment effect was consistent across patients with and without CKD, suggesting that baseline renal function did not significantly influence DCB outcomes over 2 years.

OPHTHALMOLOGY

Study evaluates female representation in onchocerciasis and trachoma clinical trials, highlighting disparities in equitable recruitment.

Female Representation in Onchocerciasis and Trachoma Clinical Trials

A cross-sectional analysis evaluates female representation in randomized interventional clinical trials for onchocerciasis and trachoma using real-world disease prevalence estimates. The study included 103 trials involving 327,468 participants. Overall female enrolment was slightly lower than expected (PPR 0.88). Trachoma trials demonstrated equitable representation, while onchocerciasis trials showed substantial underrepresentation, with 29% enrolling no female participants. The findings highlight the importance of equitable recruitment and sex-disaggregated reporting in clinical research on neglected tropical eye diseases.

Ankylosing spondylitis was linked to a 40% higher PAD risk, especially among younger women, supporting early vascular assessment.

Ankylosing Spondylitis Linked to Higher Peripheral Artery Disease Risk

A nationwide South Korean cohort study found that people with ankylosing spondylitis (AS) had a 40% higher risk of peripheral artery disease (PAD) than matched controls. The risk was particularly elevated among women younger than 60 years, highlighting the importance of early vascular risk assessment and tailored prevention in AS.

FAMILY HEALTH

Blinatumomab improved 4-year event-free survival versus chemotherapy in children with high-risk B-cell ALL.

Blinatumomab Improves Survival in Children With High-Risk B-ALL

A randomized trial in 709 children with newly diagnosed high-risk B-cell acute lymphoblastic leukemia found that replacing two cycles of conventional chemotherapy with blinatumomab increased estimated 4-year event-free survival to 83.0% versus 70.3%. Treatment-related infections and life-threatening adverse events were also less frequent, although neurotoxic events were more common with blinatumomab.

Five-year colonoscopy surveillance was noninferior to 3-year surveillance for colorectal cancer after high-risk adenoma removal.

5-Year Colonoscopy Interval Noninferior After High-Risk Adenoma Removal

An interim analysis of a 10,799-patient European trial found that starting surveillance colonoscopy 5 years after removal of high-risk adenomas was noninferior to starting at 3 years. At 5 years, colorectal cancer incidence was 0.77% with 5-year surveillance versus 0.82% with 3-year surveillance, with no substantial difference in cancer stage at diagnosis.

Insomnia co-fluctuated with PTSD and depression over 10 years but did not predict later symptoms in military personnel.

Insomnia Linked to PTSD and Depression Symptoms in Military Personnel

A 10-year study of 846 Dutch military personnel found strong, persistent co-fluctuation between insomnia, PTSD and depression symptoms from before deployment through post-deployment follow-up. Insomnia did not predict later PTSD or depression, suggesting that sleep problems may reflect shared underlying vulnerabilities rather than independently driving these conditions.

UROLOGY

Endoscopic kidney-sparing surgery supported renal preservation in UTUC patients with a solitary kidney despite frequent recurrence.

Kidney-Sparing Surgery in UTUC With a Solitary Kidney

A multicentre study of 62 patients with upper tract urothelial carcinoma (UTUC) and a solitary kidney found that endoscopic kidney-sparing surgery enabled renal preservation despite frequent recurrences and repeated ureteroscopies. At 5 years, recurrence was 70%, progression 40%, and dialysis dependency 32%, supporting eKSS as an option when preserving the kidney is clinically imperative.

Surviving Sepsis Campaign...

Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU: First Update