CRITICAL CARE

Parapneumonic effusion and empyema cases are increasing globally, particularly among the elderly with comorbidities. The use of pneumococcal vaccines has led to the emergence of nonvaccine-type pneumococci and other bacteria, contributing to this rise. Prompt treatment with appropriate antibiotics is crucial, guided by local guidelines and antimicrobial resistance patterns. Thoracic ultrasound has become a leading imaging technique, allowing physicians to assess effusions and underlying lung tissue and guide pleural procedures safely. Drainage decisions rely on established criteria, while small-bore chest drains are as effective as large bore and suitable for intrapleural enzyme therapy.

Managing Parapneumonic Effusion and Empyema in Elderly Patients with Comorbidities: Importance of Prompt Treatment and Thoracic Ultrasound Guidance

DENTISTRY

Experimental antibiotic paste showed improved cytocompatibility and cell viability, supporting further study in regenerative endodontics.

Experimental Triple Antibiotic Paste Shows Promise in Regenerative Endodontics

An experimental triple antibiotic paste containing nitrofurantoin, ciprofloxacin, and metronidazole showed better cytocompatibility than conventional Hoshino antibiotic pastes and calcium hydroxide in human dental pulp stem cells. The paste maintained about 75% metabolic activity and better preserved cell viability, supporting further investigation as a medicament for regenerative endodontic procedures.

DERMATOLOGY

Dupilumab improved atopic dermatitis clinically, but persistent RCM abnormalities suggested incomplete microstructural normalization.

Dupilumab Improves Atopic Dermatitis but Leaves Persistent RCM Changes

A prospective real-world study of 37 patients with moderate-to-severe atopic dermatitis found substantial clinical improvement after 24 weeks of dupilumab, with 76.2% achieving EASI-75. However, reflectance confocal microscopy showed persistent epidermal disorganization, spongiosis and dilated vessels, suggesting that clinical response may not always reflect complete microstructural recovery.

CARDIOLOGY

Sacubitril/valsartan was associated with stable renal function and low event rates over 24 months in HFrEF with stage 3–4 CKD.

Sacubitril/Valsartan Shows Stable Renal Function in HFrEF With CKD

A retrospective cohort of 360 adults with HFrEF and stage 3–4 CKD found that sacubitril/valsartan was generally well tolerated over 24 months. Mean eGFR remained stable among survivors, while NT-proBNP, CRP and NYHA class improved. The renal composite occurred in 3.3% and mortality was 6.1%. As a single-arm study, the findings are descriptive and require controlled confirmation.

PULMONOLOGY

GLP-1 therapy was associated with fewer asthma exacerbations and respiratory events in adults with obesity.

GLP-1 Therapy Linked to Fewer Asthma Exacerbations in Obesity

A US retrospective cohort study of 4,846 adults with obesity and asthma found that GLP-1-based therapy was associated with fewer one-year asthma exacerbations than non-GLP-1 weight-management therapy. Exacerbations occurred in 1.7% vs 4.0%, alongside lower glucocorticoid exposure, emergency/critical-care use, and acute respiratory failure. Residual confounding prevents causal conclusions.

Herbal formula ZiYuShuang improved skin hydration, dermal properties and wrinkle severity in clinical evaluation.

Herbal Formula ZiYuShuang Shows Potential Against Skin Aging

A study combining network medicine, laboratory testing and clinical evaluation identified ZiYuShuang (ZYS), an herbal formula targeting skin aging pathways. In clinical testing, ZYS improved skin hydration, glossiness, transparency, dermal density and thickness while reducing redness, roughness and wrinkle severity. Its effects were linked to pathways involving PI3K-Akt, TNF, apoptosis and focal adhesion.

NEUROLOGY

Review highlights inconsistent iRBD risk disclosure and calls for structured communication about neurodegenerative disease risk.

iRBD Risk Disclosure for Neurodegenerative Disease Needs Structured Approach

A scoping review of eight studies examined how risk of neurodegenerative disease progression is communicated to people with isolated REM sleep behaviour disorder (iRBD). Patients generally want comprehensive, reliable information, while clinicians report challenges including prognostic uncertainty, ethical concerns and potential emotional effects. The review highlights the need for a structured disclosure approach.

Sleep disturbances were linked to early cerebral small vessel disease changes, highlighting potential opportunities for earlier detection.

Sleep Disturbances and Cerebral Small Vessel Disease in Aging

A population-based study of 154 adults found that a higher proportion of light sleep relative to deep sleep was associated with greater microstructural brain changes and lower cortical thickness linked to cerebral small vessel disease. Home sleep monitoring and high-resolution neuroimaging may support earlier detection of cerebrovascular changes, although longitudinal studies are needed to establish causality.

ENDO-DIABETOLOGY

Review highlights four obesity phenotypes and supports phenotype-based approaches to improve cardiometabolic risk assessment.

Obesity Phenotypes Offer Better Cardiometabolic Risk Assessment Beyond BMI

A review highlights obesity as a heterogeneous condition and examines four phenotypes: metabolically healthy obesity, metabolically unhealthy obesity, metabolically obese normal weight, and sarcopenic obesity. Differences in fat distribution, inflammation, metabolism, and muscle function can produce distinct cardiometabolic risks despite similar BMI. The findings support phenotype-informed risk assessment and personalized prevention and treatment.

Visceral and ectopic fat drive metabolic and organ dysfunction but can be reduced through lifestyle and obesity therapies.

Visceral and Ectopic Fat in Obesity-Related Disease

A review highlights how excess visceral and ectopic fat contributes to insulin resistance, inflammation, and dysfunction across the liver, pancreas, heart, kidneys, skeletal muscle, and upper airway. It links these fat depots with MASLD, type 2 diabetes, cardiovascular and renal disease, sarcopenic obesity, and sleep apnea, while noting that lifestyle, incretin therapies, and bariatric surgery can reduce ectopic fat.

Obesity and OSA reinforce each other, while weight loss interventions may reduce apnea severity and cardiometabolic risk.

Obesity and Obstructive Sleep Apnea: Bidirectional Link

A review examines the bidirectional relationship between obesity and obstructive sleep apnea (OSA), with OSA prevalence reaching up to 90% in Class III obesity. Airway fat accumulation, reduced lung volumes, inflammation, sleep fragmentation, and hormonal disruption contribute to the cycle. Weight loss through lifestyle changes, GLP-1 receptor agonists, and bariatric surgery can reduce apnea severity and cardiometabolic risk.

OPHTHALMOLOGY

Trifocal IOLs provided good distance vision in highly myopic eyes, but patient selection and counselling remain important.

Trifocal IOL Outcomes in Highly Myopic Eyes

A retrospective study of 361 highly myopic eyes found that trifocal intraocular lenses significantly improved corrected distance visual acuity, with 80.1% achieving a postoperative spherical equivalent within ±0.50 D. However, nearly one-fifth did not reach predefined distance vision targets and 8% required corneal refractive enhancement, highlighting the importance of patient selection and counselling.

Repeat XEN implantation reduced IOP and medication burden over 12 months in eyes with prior XEN failure.

Repeat XEN Gel Stent Outcomes After Prior XEN Failure

A 12-month retrospective study of 24 eyes with previous XEN stent failure found that repeat XEN implantation reduced mean intraocular pressure by 43.5%, from 23.50 to 13.28 mmHg. IOP-lowering medications fell by 57%, while qualified success reached 66.7%. No vision-threatening complications were reported, supporting repeat XEN as a potential option before more invasive surgery.

FAMILY HEALTH

Polygenic risk scores and pharmacogenomics could expand genomic medicine into prevention and treatment of common diseases.

Polygenic Risk Scores and Pharmacogenomics in Clinical Care

Twenty-five years after the draft human genome sequence, genomics has transformed rare disease diagnosis and targeted cancer therapies but has had limited impact on common adult-onset diseases. This review examines why polygenic risk scores have been slow to enter clinical practice and explores how genomic sequencing, polygenic risk assessment, and pharmacogenomics could support prevention and treatment of common diseases.

XEN gel stent implantation reduced IOP and medication burden in Chinese patients with refractory glaucoma over 12 months.

XEN Gel Stent Outcomes in Chinese Refractory Glaucoma

Final 12-month data from a real-world phase 3b study in 59 Chinese eyes with refractory glaucoma showed that XEN gel stent implantation reduced mean IOP from 23.7 to 17.4 mmHg and glaucoma medications from 3.3 to 1.0. Nearly half of eyes achieved the primary effectiveness outcome, with no intraoperative complications or unexpected safety findings.

RHEUMATOLOGY

Study finds high supplement use and potential supplement–medication interactions among adults with systemic lupus erythematosus.

Dietary Supplement Use and Drug Interactions in SLE

A study of 451 adults with systemic lupus erythematosus found that 80.9% used at least one dietary supplement, with vitamin D, multivitamins and calcium most common. Nearly one-third (29.5%) had a supplement–medication combination with potential for interaction, highlighting the need for routine supplement review, particularly in patients with polypharmacy.

Expert Review on Nonsurgi...

Expert Review on Nonsurgical Management of Parapneumonic Effusion: Advances, Controversies, and New Directions