GYNAECOLOGY - IVF

Ensuring optimal recovery post-cesarean delivery is vital, and effective pain management plays a crucial role. This retrospective cohort analysis investigates the impact of integrating enhanced recovery after cesarean (ERAC) protocols into an existing approach that combines neuraxial morphine and wound catheters with continuous bupivacaine infusions. The study aims to determine whether ERAC further reduces opioid consumption post-cesarean delivery, contributing valuable insights to refining postoperative pain management strategies.

Enhanced Recovery after Cesarean: Impact on Postoperative Pain Management and Opioid Consumption

GASTROENTEROLOGY

Multimodal monitoring and early ammonia control are crucial for managing hepatic encephalopathy in acute liver failure.

Multimodal Monitoring Key to Managing Hepatic Encephalopathy in Acute Liver Failure

A comprehensive review underscores that hepatic encephalopathy (HE), a life-threatening neurological complication of acute liver failure (ALF), is primarily driven by hyperammonemia, with inflammation and cerebral dysfunction further worsening brain injury. Experts emphasize that no single test can adequately assess neurological involvement. Instead, multimodal neuromonitoring—including neurological examination, ammonia kinetics, cerebral hemodynamics, and neuroimaging—is crucial for early detection and timely intervention. The review advocates evidence-based strategies such as continuous renal replacement therapy, cerebral protection measures, plasma exchange in selected cases, and structured neurocritical care to improve outcomes and guide decisions on advanced liver support and transplantation

RHEUMATOLOGY

The ALARN score accurately predicts long-term mortality risk in patients with antisynthetase syndrome.

ALARN Score Validated as a Simple Predictor of Mortality in Antisynthetase Syndrome

Researchers have developed and validated the ALARN score, a simple prognostic tool to predict all-cause mortality in patients with antisynthetase syndrome (ASyS). Derived from data on 1,194 patients across three Chinese institutions, the score incorporates five readily available factors: age at onset, lactate dehydrogenase, albumin, respiratory failure, and neutrophil-to-lymphocyte ratio. The model demonstrated excellent predictive accuracy for 1-, 3-, 5-, and 10-year mortality and successfully stratified patients into low-, intermediate-, and high-risk groups. The ALARN score offers clinicians a practical tool for risk assessment, prognostication, and personalized patient management.

CARDIOLOGY

Baxdrostat significantly lowers blood pressure in resistant hypertension with manageable hyperkalemia risk.

Baxdrostat Significantly Lowers Blood Pressure in Resistant Hypertension

A new systematic review and meta-analysis of three phase 2/3 clinical trials involving 1,285 patients found that baxdrostat, a selective aldosterone synthase inhibitor, significantly lowers blood pressure in patients with resistant and uncontrolled hypertension. The drug achieved a pooled reduction of nearly 9.5 mmHg in seated systolic blood pressure and a 14 mmHg reduction in 24-hour ambulatory systolic blood pressure, with a clear dose-response relationship. Importantly, cortisol levels remained unaffected, demonstrating high selectivity. Although the risk of hyperkalemia increased, it was considered manageable with appropriate monitoring. Long-term cardiovascular outcome studies are needed before baxdrostat can be incorporated into hypertension treatment guidelines.

OPHTHALMOLOGY

Study shows eye pain in Graves' orbitopathy affects QoL and significantly improves with IVMP therapy.

Eye Pain in Graves' Orbitopathy Improves with IVMP and Predicts Better Quality of Life

Abstract

Purpose
Pain is included in the clinical activity score (CAS) as an indicator of inflammatory activity in Graves' orbitopathy (GO), yet its clinical relevance has not been systematically evaluated. We therefore investigated the relationship between pain, other inflammatory signs and quality of life (QoL), and assessed the effect of intravenous methylprednisolone (IVMP) treatment on pain perception in GO.


Methods
In this prospective study, 40 patients with GO were assessed pre‐treatment and 12 and 24 weeks after initiation of IVMP treatment. Pain was measured using numeric rating scale (NRS) scores for spontaneous retrobulbar pain, pain on eye movements and pain on touching the eye. QoL was evaluated using the TED‐QOL and GO‐QOL questionnaires.


Results
Pre‐treatment NRS scores correlated with their corresponding CAS pain items, but not with the total 5‐item CAS. Pre‐treatment QoL correlated with spontaneous retrobulbar pain and pain on eye movements. In multivariate analysis, clinically meaningful improvement in pain on eye movements at 12 weeks independently predicted improvement in TED‐QOL and GO‐QOL appearance. At 24 weeks, improvement in pain on touching the eye independently predicted improvement in TED‐QOL function. IVMP significantly reduced NRS pain scores at both follow‐up visits. At 12 weeks, changes in total 5‐item CAS correlated with changes in pain on eye movements and pain on touching the eye.


Conclusions
Pain perception in GO is closely associated with QoL, both pre‐treatment and in response to IVMP. Pain represents a clinically relevant, treatment‐responsive component of GO, supporting the inclusion of pain items within the CAS.

DENTISTRY

AI tools show high accuracy in detecting hidden root canals and may enhance endodontic diagnosis and outcomes.

AI Improves Detection of Hidden Root Canals in Endodontics, Review Finds

A new systematic review highlights the growing potential of artificial intelligence (AI) in identifying difficult-to-detect accessory root canals, including second mesiobuccal (MB2) and middle mesial canals (MMC), which are often missed and can compromise endodontic success. Across seven studies, AI models demonstrated high sensitivity (80–100%) and specificity (99.4–100%) for canal detection, particularly on cone-beam computed tomography (CBCT). Technologies such as U-Net, YOLO, CNNs, and ChatGPT-4o showed encouraging results, suggesting AI could become a valuable adjunct in improving diagnostic accuracy and treatment outcomes in endodontics, although further validation is needed.

Two PRP injections significantly improve smell function in patients with persistent olfactory dysfunction

Two PRP Injections Improve Olfactory Function in Persistent Smell Disorders

A prospective study suggests that two injections of platelet-rich plasma (PRP) into the olfactory clefts can significantly improve smell function in patients with long-standing olfactory dysfunction, including anosmia, hyposmia, and parosmia. Among 83 participants, nearly 76% achieved clinically meaningful improvement from baseline to final assessment, with gains observed after both injections. The treatment was generally well tolerated, with transient nosebleeds being the most common adverse event. In contrast, control patients undergoing olfactory training showed limited improvement. The findings position repeated PRP injections as a promising therapeutic approach for persistent smell disorders, although further studies are needed to define the optimal treatment regimen.

PEDIATRICS

Pediatric IgA nephropathy shows highly variable kidney outcomes, underscoring the need for long-term monitoring.

Study Reveals Variable Kidney Outcomes in Pediatric IgA Nephropathy

A new single-center study highlights the highly variable nature of pediatric IgA nephropathy (IgAN), challenging the notion that the disease generally follows a benign early course. Among 14 children followed for a median of five years, kidney function remained stable in 57% of patients, declined in 21%, and improved in 14%, suggesting that renal trajectories can range from deterioration to partial recovery. Active histological lesions, including mesangial and endocapillary hypercellularity, were common. One child developed severe acute kidney injury requiring temporary dialysis but recovered fully. The findings emphasize the need for long-term monitoring and larger studies to better understand disease progression and prognostic markers in pediatric IgAN.

PSYCHIATRY

Older survivors of Hamas captivity showed notable resilience, though grief and maltreatment increased trauma risk.

Older Adults Show Resilience Following Hamas Captivity, Study Finds

A preliminary study of older Israeli survivors exposed to the October 7 attacks found unexpectedly low levels of posttraumatic stress, depression, anxiety, and prolonged grief, even among those released from Hamas captivity. Compared with non-captive displaced survivors, former captives showed similar psychological outcomes, except for higher levels of prolonged grief. However, ex-captives who experienced malicious maltreatment during captivity were more likely to develop elevated posttraumatic responses. The study also found that loneliness and a reduced sense of safety were linked to worse psychological outcomes among former captives. The findings support the idea that many older adults may demonstrate significant resilience even after extreme trauma while highlighting factors that increase vulnerability.

ENDO-DIABETOLOGY

Proteomics identifies three pre-diabetes subtypes and improves prediction of type 2 diabetes risk.

Proteomics Identifies Three Pre-Diabetes Subtypes to Improve Type 2 Diabetes Prediction

A large UK Biobank study involving more than 41,000 adults has identified three distinct pre-disease subtypes of type 2 diabetes using proteomic profiling: a metabolically healthy group (MHG), mild inflammation group (MIG), and dyslipidemia with inflammation group (DLIG). The DLIG subgroup had the highest risk of developing type 2 diabetes, with a 2.6-fold increased risk compared with the metabolically healthy group. Researchers found that subgroup-specific proteomic prediction models significantly outperformed traditional clinical risk models, paving the way for earlier detection and precision prevention strategies tailored to an individual's biological risk profile.

UROLOGY

New therapies significantly reduce years of life lost in metastatic prostate cancer, but racial disparities persist.

Modern Therapies Reduce Years of Life Lost in Metastatic Prostate Cancer

A large real-world analysis of more than 36,000 patients with metastatic prostate cancer (mPCa) found that advances in systemic therapies have substantially reduced years of life lost (YLL) across all racial and ethnic groups. The greatest improvement was observed with the introduction of androgen receptor pathway inhibitors (ARPIs), which markedly lowered YLL compared with earlier treatment eras. Despite these gains, significant disparities remain, with African American patients consistently experiencing the highest YLL across all treatment periods. The findings confirm the survival benefits of modern therapies while underscoring the urgent need to address persistent racial inequities in metastatic prostate cancer outcomes.

NEUROLOGY

Persistent inflammation may underlie long-term disability after intracerebral hemorrhage, offering new therapeutic targets.

Failed Inflammation Resolution May Drive Long-Term Disability After Intracerebral Hemorrhage

A new perspective challenges the traditional understanding of neuroinflammation following intracerebral hemorrhage (ICH), proposing that long-term disability results from the brain's inability to properly resolve acute inflammation. Researchers suggest that dysregulation of key molecular pathways, particularly the USP11–p53 axis, traps the brain in a persistent inflammatory state, leading to progressive white matter damage, gliosis, and network disconnection. The authors introduce the concept of post-ICH sequelae, encompassing chronic motor, cognitive, and emotional impairments. They advocate shifting from broad immunosuppression toward precision therapies that promote inflammation resolution, such as USP11 inhibitors guided by biomarker-based immune staging.

Wet suction reduces blood contamination and improves cellularity in endoscopic ultrasound-guided biopsies.

Wet Suction Improves Sample Quality in Endoscopic Ultrasound-Guided Tissue Acquisition

A new meta-analysis of seven randomized controlled trials involving 784 patients suggests that the wet-suction technique enhances specimen quality during endoscopic ultrasound-guided tissue acquisition (EUS-TA). Compared with conventional dry suction, wet suction significantly reduced blood contamination and improved cellularity of tissue samples. While overall diagnostic accuracy was similar between the two techniques, wet suction demonstrated a significant advantage in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) procedures. No clear differences were observed in specimen integrity or adequacy. The findings indicate that wet suction may optimize tissue sampling and potentially improve diagnostic performance, although larger standardized studies are needed.

PULMONOLOGY

Low miR-192-5p levels may help identify pulmonary heart disease early in patients with COPD.

miR-192-5p Shows Promise as an Early Biomarker for Pulmonary Heart Disease in COPD

A new study suggests that miR-192-5p could serve as a promising biomarker for the early detection of pulmonary heart disease (PHD) in patients with chronic obstructive pulmonary disease (COPD). Researchers found significantly lower serum levels of miR-192-5p in patients with PHD, with the biomarker demonstrating moderate diagnostic accuracy in distinguishing COPD patients with and without PHD (AUC 0.789). Low miR-192-5p expression was also identified as an independent risk factor for PHD development and was closely linked to increased inflammation and impaired cardiopulmonary function. These findings highlight the potential of miR-192-5p as a non-invasive tool for early diagnosis and risk assessment in COPD-associated PHD.

Combined radiofrequency and exosome therapy may improve symptoms in refractory vulvar lichen sclerosus.

Radiofrequency and Exosome Therapy May Benefit Refractory Vulvar Lichen Sclerosus

A first-of-its-kind case report suggests that combining ablative fractional radiofrequency (RF) with topical lyophilized exosomes may offer a new treatment option for patients with refractory vulvar lichen sclerosus (VLS). A 38-year-old woman with biopsy-confirmed VLS who had failed standard corticosteroid therapy experienced significant improvements in itching, painful intercourse, sexual function, and overall satisfaction following treatment. The exosomes, derived from amniotic fluid stem cells, are thought to promote tissue regeneration and may enhance the effects of RF therapy. While the findings are preliminary and based on a single patient, they open the door to exploring regenerative therapies for difficult-to-treat VLS.

DERMATOLOGY

Ashwagandha extract improves hydration, elasticity, and wrinkles in sensitive skin by targeting CCN1 pathways.

Ashwagandha Extract Improves Signs of Aging in Sensitive Skin, Study Finds

New research suggests that Ashwagandha root extract (ARE) may help combat aging in sensitive skin by targeting Cellular Communication Network Factor 1 (CCN1), a key regulator of oxidative stress and inflammation. In laboratory studies, ARE improved fibroblast survival, reduced inflammatory markers, and promoted collagen production. In a 28-day clinical study involving 31 women with sensitive skin, an ARE-containing cream significantly increased skin hydration by 49% and elasticity by 27%, while improving firmness, reducing wrinkles, and decreasing facial sagging. The findings support ARE as a promising, well-tolerated ingredient for managing signs of aging in sensitive skin.

Evolution of postoperativ...

Evolution of postoperative care: marked reduction of opioid consumption