GENERAL MEDICINE

A recent pharmacoepidemiological study across global databases, including the US, Spain, Germany, UK, France, Scotland, Hong Kong, and Australia, assessed second-line antihyperglycaemic drug usage in 4.8 million adults with type 2 diabetes on metformin monotherapy. Between 2011-21, the initiation of cardioprotective drugs (GLP-1 receptor agonists and SGLT-2 inhibitors) as second-line treatment rose, constituting 35.2%-68.2% in the US, 15.4% in France, 34.7% in Spain, 50.1% in Germany, and 54.8% in Scotland in 2021. Surprisingly, patients with cardiovascular disease showed lower uptake than those without. The study calls for strategies aligning drug use with guidelines to enhance outcomes for type 2 diabetes patients, indicating a need for targeted interventions in cardiovascular disease populations.

Global Trends in Second-Line Antihyperglycaemic Drug Usage Among Adults with Type 2 Diabetes: Insights from a Pharmacoepidemiological Study

GASTROENTEROLOGY

YAQ001 may improve gut microbiome profiles and reduce inflammation-related markers in patients with cirrhosis.

YAQ001 and Gut Microbiome Changes in Cirrhosis

A randomized, double-blind substudy involving 28 patients with cirrhosis found that YAQ001, a gut-restricted carbon bead adsorbent, increased beneficial bacteria and reduced potentially harmful microbes and antibiotic resistance genes. These changes were associated with lower gut permeability and systemic inflammation markers. YAQ001 also inhibited Klebsiella pneumoniae biofilm formation in vitro, supporting further investigation of its microbiome-targeted potential.

ENDO-DIABETOLOGY

GLP-1 agonists may influence obesity-related cancer risk, but long-term benefits and safety concerns require further study.

GLP-1 Agonists and Obesity-Related Cancer Risk

GLP-1 receptor agonists, increasingly used to treat obesity, may help reduce the risk of certain obesity-associated cancers through weight loss, improved metabolic health and reduced inflammation. Current evidence does not indicate an increase in overall cancer risk, but concerns such as medullary thyroid carcinoma warrant attention. Sustained benefits may depend on long-term weight management, lifestyle interventions and preservation of muscle mass.

NEUROLOGY

Higher medial temporal lobe blood flow may indicate cognitive resilience in APOE ε4 carriers without Alzheimer’s pathology.

Brain Blood Flow and Cognitive Resilience in APOE ε4 CarriersBrain Blood Flow and Cognitive Resilience in APOE ε4 Carriers

A study of 148 cognitively unimpaired older adults found higher medial temporal lobe cerebral blood flow in APOE ε4 carriers. Increased blood flow was associated with better executive function only in carriers without elevated plasma pTau217, a marker of Alzheimer’s disease pathology. The findings suggest that hyperperfusion may indicate cognitive resilience in the absence of detectable Alzheimer’s-related changes.

UROLOGY

Round-headed sperm proportions may predict sperm function and IVF/ICSI outcomes, supporting individualized fertility care.

Round-Headed Sperm and IVF/ICSI Outcomes

A retrospective case-control study found that men with higher proportions of round-headed sperm had poorer sperm function, increased DNA damage and reduced acrosome integrity. A 7.2% threshold helped distinguish reproductive outcomes, with higher proportions associated with lower fertilization, high-quality embryo, clinical pregnancy and live birth rates following IVF/ICSI. The findings may support individualized fertility assessment and treatment planning.

RAS inhibitors are associated with improved survival in gastroesophageal cancers, but prospective studies are needed to confirm benefits.

RAS Inhibitors and Survival in Gastroesophageal Cancers

A meta-analysis of 12 observational studies involving 15,062 patients found that renin–angiotensin system (RAS) inhibitor use was associated with improved overall, cancer-specific and disease-free survival in gastric and esophageal cancers. However, small-study effects and the observational nature of the evidence limit causal conclusions. Prospective studies are needed before considering RAS inhibitors for anticancer purposes beyond established indications.

AI models show promise in urodynamic interpretation, but external validation and prospective studies are needed for clinical use.

AI in Urodynamic Studies: Diagnostic Accuracy and Limitations

A narrative review of 12 studies found that machine learning and deep learning models can support the interpretation of urodynamic studies, identifying detrusor overactivity, bladder outlet obstruction and detrusor underactivity. Reported accuracy or AUC ranged from 80% to 95% for many primary outcomes. However, limited external validation, retrospective datasets and methodological variability remain barriers to routine clinical adoption.

Urinary incontinence is linked to higher mortality risk, but very low-certainty evidence warrants cautious interpretation.

Urinary Incontinence and All-Cause Mortality Risk

A systematic review and meta-analysis of 17 studies involving 82,739 participants found that urinary incontinence was associated with a 20% higher risk of all-cause mortality. The association appeared stronger with increasing incontinence severity. However, substantial heterogeneity and very low certainty of evidence mean that urinary incontinence may serve as a marker of frailty and declining health rather than a direct cause of mortality.

PSYCHIATRY

Two studies explore how childhood betrayal trauma relates to shame, dissociation and fear of social connection.

Childhood Betrayal Trauma, Shame and Dissociation

Two studies examining representative age- and gender-based general population samples explored how childhood betrayal trauma relates to shame, dissociation and fear of belonging. Findings suggest that shame and dissociation may influence difficulties in social connection, while the perceived impact of traumatic experiences may shape these outcomes. The results highlight the potential importance of addressing trauma-related psychological responses in mental health care.

DENTISTRY

A review of 17 studies identifies chemical pretreatments that may improve resin composite bonding and dentin bond durability.

Chemical Dentin Pretreatments and Resin Bond Strength

A systematic review of 17 in vitro studies found that selected chemical pretreatments may improve resin composite bonding to sound dentin and support long-term bond durability. Approaches including dimethyl sulfoxide, selective dentin etching, copper-based pretreatments and collagen cross-linkers showed promising results. Silver-based solutions reduced bond strength, highlighting the importance of selecting appropriate pretreatment strategies in adhesive dentistry.

OPHTHALMOLOGY

AS-OCT reveals differences in Schlemm’s canal area between open- and narrow-angle eyes, warranting further clinical research.

Schlemm’s Canal OCT Imaging in Open- and Narrow-Angle Eyes

A cross-sectional study of 97 eyes found that Schlemm’s canal cross-sectional area was significantly larger in open-angle than narrow-angle eyes (4,704 vs 3,222 µm²; p=0.003). Anterior segment OCT showed good measurement reproducibility for canal area, particularly in nasal images. However, further longitudinal research is needed to establish its clinical value in glaucoma assessment and aqueous outflow evaluation.

Study links CD52-positive fibroblasts to inflammation-associated prostate remodeling in mice and human prostate tissue.

Prostate Inflammation and Immune-Reactive Fibroblasts in BPH

A study using single-cell RNA sequencing found that chronic Toxoplasma gondii infection drives selective stromal remodeling in mouse prostates, with expansion of CD52-positive, CCL5-positive immune-reactive fibroblasts. Human prostate tissue also showed significant enrichment of CD52-positive fibroblasts in inflamed regions (p=0.0026). These findings may improve understanding of inflammation-associated prostate changes, including those relevant to benign prostatic hyperplasia (BPH).

Study finds 24.2% of men with suspicious prostate MRI and negative biopsy later had clinically significant prostate cancer.

Prostate MRI and Follow-Up After a Negative Biopsy

A longitudinal analysis of 153 men with suspicious prostate MRI findings but no clinically significant cancer on initial biopsy found that 24.2% were subsequently diagnosed with clinically significant prostate cancer. Nearly 76% of these diagnoses occurred within six months. Findings highlight the importance of follow-up, while selective repeat biopsy and incomplete histological confirmation limit interpretation.

Review explores drama-based therapies for trauma, highlighting potential mental health benefits and very low certainty of evidence.

Drama-Based Interventions for Trauma and Mental Health

A systematic review of 26 studies found that drama-based interventions, including psychodrama, dramatherapy and applied theatre, may improve psychological outcomes in trauma-exposed populations. Depression, anxiety and PTSD symptoms were the most frequently assessed outcomes. However, mixed findings, small samples and methodological limitations led to very low certainty of evidence, highlighting the need for more rigorous research.

DERMATOLOGY

Study finds antibiotics improve skin microbiome imbalance in hidradenitis suppurativa, unlike the tested biologic therapies.

Hidradenitis Suppurativa: Antibiotics and Skin Microbiome Changes

A study analysing skin samples from 52 patients with hidradenitis suppurativa (HS) and 31 healthy controls identified significant microbial imbalances, including depletion of beneficial bacteria and expansion of anaerobic pathogens. After 12 weeks, clindamycin/rifampicin reduced pathogen levels and increased microbial richness, while adalimumab and secukinumab showed no comparable improvement in microbial balance.

Study compares the cost-effectiveness of app-based, therapist-led and paper-based swallowing exercises during cancer treatment.

Cost-Effectiveness of Swallowing Exercises in Head and Neck Cancer

A secondary analysis of the PRESTO trial involving 150 patients receiving (chemo)radiotherapy for oropharyngeal head and neck cancer found no significant differences in health utility outcomes between app-based, therapist-led and paper-based swallowing exercises. Paper-based self-management was more cost-effective than app-based delivery, while therapist-led sessions cost more, with an incremental cost-effectiveness ratio of €124,061.54 per QALY.

Multinational patterns of...

Multinational patterns of second-line anti-hyperglycaemic drug initiation across cardiovascular risk groups