GASTROENTEROLOGY

Recent trials challenge current approaches to managing acute pancreatitis, including fluid resuscitation, antibiotics, infected necrosis management, and early endoscopic retrograde cholangiopancreatography. With considerable morbidity, this common digestive disease lacks effective treatments, requiring supportive care. New evidence calls for reassessing current guidelines. Clinical Outlook explores these advances and their implications.

Advances in Managing Acute Pancreatitis: Reassessing Guidelines and Treatment Approaches - Clinical Outlook

RHEUMATOLOGY

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.

NEUROLOGY

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.

Tofacitinib improved PMR disease activity and reduced prednisone exposure when combined with steroids in a 6-month study.

Tofacitinib May Reduce Steroid Exposure in Polymyalgia Rheumatica

A retrospective study of 60 patients with polymyalgia rheumatica (PMR) found that tofacitinib-containing regimens improved disease activity, inflammatory markers, pain and morning stiffness over 6 months. Combining tofacitinib with prednisone was associated with significantly lower daily and cumulative prednisone exposure, with no serious adverse events reported during follow-up.

A Lebanese study identifies adult age as an independent risk factor for post-tonsillectomy hemorrhage.

Adult Age Increases Post-Tonsillectomy Hemorrhage Risk

A 10-year retrospective study of 945 patients at a Lebanese tertiary care center reported a 2.65% prevalence of post-tonsillectomy hemorrhage. Secondary bleeding accounted for 92% of cases and typically occurred around postoperative day 7. Adults had higher bleeding rates than children (7.4% vs. 1.9%), with adult age independently associated with increased risk (aOR 2.93).

ORTHOPAEDICS

Short-course systemic antibiotics were noninferior to longer therapy after orthopedic infection surgery with local antibiotic carriers.

Short-Course Antibiotics Effective After Orthopedic Infection Surgery

In a multicenter randomized trial of 500 patients undergoing orthopedic infection surgery with local antibiotic carriers, systemic antibiotics for ≤7 days were noninferior to ≥4 weeks for treatment failure at 12 months. Failure occurred in 11.1% versus 14.1%, respectively, while treatment-related symptoms by week 6 were less frequent with short-course therapy (17.2% vs 45.2%).

OPHTHALMOLOGY

Exploratory findings link higher flavoprotein fluorescence with retinal nerve fiber layer thinning in glaucoma.

Flavoprotein Fluorescence and RNFL Thinning in Glaucoma

An exploratory study of 73 eyes from 54 patients examined flavoprotein fluorescence using the OcuMet Beacon device. Higher optic nerve head and peripapillary fluorescence was associated with older age and thinner retinal nerve fiber layers. Inferior peripapillary fluorescence showed a significant association with RNFL thinning after adjustment for relevant factors.

Non-linear aspheric micro-monovision LASIK achieved strong visual outcomes and high patient satisfaction at 12 months.

Micro-Monovision LASIK Shows Positive Outcomes in Presbyopia

A retrospective study of 319 patients treated with PRESBYOND® Laser Blended Vision reported strong visual outcomes at 12 months. Binocular uncorrected distance vision reached 20/20 or better in 98% of myopic and 93% of hyperopic patients. Near vision reached N6 or better in 99% and 96%, respectively, while 89% of patients reported satisfaction.

GYNAECOLOGY - IVF

A Tanzanian study links HIV infection to increased recurrence of preinvasive cervical lesions after LEEP treatment.

HIV and Recurrence of Cervical Lesions After LEEP

A retrospective cohort study at Kilimanjaro Christian Medical Centre, Tanzania, found an 8.2% recurrence rate of preinvasive cervical lesions among 196 women followed after LEEP. HIV-positive women had higher recurrence odds (aOR 4.51), while women aged 35–49 years showed lower odds than those aged 20–34 years.

DENTISTRY

Root canal treatment reduced mechanical allodynia in adjacent and contralateral clinically sound teeth.

Root Canal Treatment Resolves Mechanical Allodynia in Sound Teeth

A study of 60 patients with symptomatic irreversible pulpitis found that root canal treatment significantly reduced mechanical allodynia in clinically sound adjacent and contralateral teeth. Improvements began within 24 hours, while near-complete resolution was observed by 3 months in almost all teeth, with one offending tooth showing persistent symptoms at 6 months.

Residual coronal tooth volume ≥41% was associated with improved 10-year survival after root canal retreatment.

Residual Coronal Volume Predicts Root Canal Retreatment Survival

A 10-year follow-up study of 156 posterior teeth found an estimated cumulative survival of 85.4% after root canal retreatment. Teeth retaining ≥41% residual coronal volume had lower extraction rates than those below this threshold (5.9% vs. 20.7%). Unfavourable 12-month CBCT findings were associated with a 4.5-fold higher extraction risk.

A narrative review explores the prevention, bleaching and restorative management of endodontic tooth discolouration.

Endodontic Tooth Discolouration: Prevention and Management

A state-of-the-art narrative review highlights the causes, diagnosis, prevention and management of endodontic tooth discolouration (DEO). It recommends preserving pulp vitality, selecting colour-stable materials, ensuring effective coronal sealing and using bleaching as the first-line treatment when appropriate.

Reduced temporalis muscle thickness was associated with greater disability and higher mortality risk in oral cancer patients.

Temporalis Muscle Thickness Linked to Oral Cancer Outcomes

A retrospective study of 527 patients with oral cancer found that reduced temporalis muscle thickness (TMT) on MRI was associated with greater disability and higher all-cause mortality. After adjustment, patients with higher TMT had significantly lower odds of severe disability and lower mortality risk, suggesting TMT may serve as an imaging-derived marker of muscle status and prognosis.

Advances in the managemen...

Advances in the management of acute pancreatitis