CRITICAL CARE

Global emergence of multidrug-resistant and extensive drug-resistant gram-negative bacteria has increased the risk of treatment failure, especially for healthcare- or ventilator-associated pneumonia (HAP/VAP). Nebulization of antibiotics, by providing high intrapulmonary antibiotic concentrations, represents a promising approach to optimize the treatment of HAP/VAP due to multidrug-resistant and extensive drug-resistant gram-negative bacteria, while limiting systemic antibiotic exposure. Aminoglycosides and colistin methane sulfonate are the most common nebulized antibiotics. Although optimal nebulized drug dosing regimen is not clearly established, high antibiotic doses should be administered using vibrating-mesh nebulizer with optimized ventilator settings to ensure safe and effective intrapulmonary concentrations...

Optimizing Treatment of Multidrug-Resistant Gram-Negative Bacteria in HAP/VAP with Nebulized Antibiotics: A Comprehensive Guide for Healthcare Professionals

GYNAECOLOGY - IVF

A cost-effectiveness model found that contingent NIPT strategies reduced false positives and invasive procedures, while universal NIPT required substantially lower prices to compete economically.

Contingent vs Universal NIPT: Cost-Effectiveness Across Healthcare Systems

A deterministic decision-analytic cohort model involving 1,000,000 pregnancies compared universal non-invasive prenatal testing (uNIPT) with contingent NIPT strategies across public, university, and private healthcare tariff systems. The analysis evaluated trisomy detection, false-positive and missed cases, invasive procedures, procedure-related fetal loss, short-term psychological quality-adjusted life year (QALY) losses, and healthcare costs. Contingent NIPT strategies substantially reduced false-positive results and invasive procedures, resulting in the lowest short-term QALY losses. In the full incremental cost-effectiveness analysis, Reflex300 was the only strategy on the cost-effectiveness frontier in private-sector scenarios, while CT and Reflex300 remained on the frontier in public-sector (SUT) and university scenarios.

ONCOLOGY

High PD-1 expression in CD8⁺ T cells was associated with Atez/Bev response in HCC, while BCAA metabolism and BCAT1 expression highlighted liver-specific mechanisms of antitumor immunity.

PD-1 and BCAA Metabolism May Predict Immunotherapy Outcomes in Liver Cancer

A study investigating hepatocellular carcinoma (HCC) patients treated with atezolizumab plus bevacizumab (Atez/Bev) explored potential biomarkers of treatment response and the role of tumor-specific metabolism. High programmed cell death-1 (PD-1) expression in CD8⁺ tumor-infiltrating lymphocytes (TILs) was associated with therapeutic response, independent of disease etiology. RNA sequencing revealed enrichment of branched-chain amino acid (BCAA)-related metabolic pathways in tumors with high PD-1 expression in CD8⁺ TILs. In vitro experiments further demonstrated the importance of BCAAs in CD8⁺ T-cell activation and differentiation.

DENTISTRY

A state-of-the-art review highlights advances in revitalization treatment, emphasizing clinical protocols, tooth survival, patient-centred outcomes, and complication management.

Revitalization Treatment: Advances in Modern Endodontics

A state-of-the-art review highlights advances in revitalization treatment for permanent teeth with incomplete root formation and pulp necrosis, expanding its applications beyond traditional cases. The review discusses patient selection, diagnostic tools, irrigation protocols, barrier placement, definitive restorations, prognosis, and complication management. It emphasizes infection control, long-term tooth survival, and patient-centred outcomes, providing updated guidance for clinical decision-making and the forthcoming European Society of Endodontology (ESE) Position Statement.

NEUROLOGY

Combining machine learning–derived brain imaging signatures with plasma biomarkers may improve Alzheimer’s disease detection and prediction of cognitive impairment.

Brain Imaging and Plasma Biomarkers Improve Alzheimer’s Disease Prediction

A study involving 1,297 participants without dementia evaluated machine learning–derived neuroimaging signatures for brain aging (SPARE-BA) and Alzheimer’s disease (SPARE-AD). SPARE-AD showed the strongest association with plasma phosphorylated tau 217 (p-tau217), while SPARE-BA correlated most strongly with plasma neurofilament light (NfL). Combining neuroimaging signatures with plasma biomarkers improved diagnostic discrimination and prediction of cognitive impairment, highlighting their potential for early detection and disease progression monitoring.

A randomized trial found that ultrasound-guided pushing reduced second-stage labor duration, significant perineal tears, and intrapartum fever in first-time mothers.

Ultrasound-Guided Pushing Reduces Labor Duration and Perineal Tears

A single-center randomized controlled trial involving 327 nulliparous women receiving epidural analgesia found that transperineal ultrasound (TPUS)-guided visual biofeedback delivered by midwives significantly reduced the duration of the second stage of labor compared with traditional coaching (107 vs 132 minutes; P = 0.001). The intervention also reduced second-degree or higher perineal tears (65.4% vs 77.3%; P = 0.020) and intrapartum fever (8.9% vs 16.4%; P = 0.043). However, the mode of delivery and key neonatal outcomes did not differ significantly. Larger studies are needed to confirm these findings and assess broader clinical benefits.

A retrospective study found that women with a previous second-stage cesarean experienced shorter labor during subsequent VBAC attempts than women with a previous elective cesarean.

Previous Labor Progress May Predict VBAC Duration

A retrospective study of 200 women attempting vaginal birth after cesarean (VBAC) at a tertiary maternity hospital in Germany found that the stage of labor reached during a previous pregnancy was associated with the duration of subsequent labor. VBAC was achieved in 75.5% of participants. Median labor duration was 12.2 hours after a previous elective cesarean, 10 hours after a cesarean during the first stage of labor, and 8 hours after a cesarean during the second stage. These findings suggest that greater cervical dilation during a previous labor may be associated with faster subsequent VBAC, although further research is needed to confirm the relationship.

OPHTHALMOLOGY

Sweden’s visual impairment registry identifies AMD and glaucoma as leading diagnoses and highlights increased use of structured assessments and individual rehabilitation plans.

Swedish Registry Reveals Trends in Visual Impairment Rehabilitation

A study using data from the Swedish Quality Registry for Rehabilitation in Visual Impairment (SKRS) analyzed adult rehabilitation records from 2016 to 2025. In 2025, the registry recorded 12,622 registrations involving 11,810 unique patients, with women accounting for 62%. Age-related macular degeneration (AMD) was the most common diagnosis (50.2%), followed by glaucoma (18.3%). Assistive technology was the most frequently recorded rehabilitation intervention (30.3%). Use of International Classification of Functioning, Disability and Health-based instruments increased to 72.5% in 2025, while individual rehabilitation plans rose to 71.8%. The findings highlight evolving rehabilitation practices and inequalities in access to visual rehabilitation.

ENDO-DIABETOLOGY

Review finds mixed cost-effectiveness of personalized obesity interventions, highlighting gaps in advanced approaches.

Cost-Effectiveness of Personalized Obesity Interventions

A systematic review of 18 studies assessed the cost-effectiveness of personalized lifestyle interventions in adults with overweight or obesity. Seven cost-utility analyses found interventions cost-effective or dominant, while four found them not cost-effective. Evidence for behavioral personalization was mixed, and data on phenotype- and omics-based approaches remained limited, highlighting the need for further economic evaluations.

Study identifies cervical screening barriers in Botswana, highlighting gaps in HPV knowledge and the need for targeted education.

Cervical Cancer Screening Barriers in Botswana

A cross-sectional study of 2,994 women in Botswana found that 67.2% had previously undergone cervical cancer screening, with higher uptake among women with HIV than those without HIV (80.0% vs 54.5%). Only 27.1% correctly identified high-risk human papillomavirus (hrHPV) as the cause. Key barriers included low prioritization, fear, lack of awareness, and service-related issues, highlighting the need for targeted education and HPV self-collection.

UROLOGY

Review examines decompression timing, drainage methods, and complications in infected obstructing urinary tract stones.

Emergency Decompression for Infected Urinary Tract Stones

Infection associated with obstructing upper urinary tract stones can progress to urosepsis and become life-threatening. A review examines key considerations in decompression and drainage before endoscopic lithotripsy, including predictive factors, indications, timing, choice of procedure, complications, and the optimal interval before definitive stone removal. The findings highlight the need for clearer evidence and consensus to guide treatment decisions.

FAERS analysis identifies potential drug-related ectopic pregnancy safety signals, warranting further clinical investigation.

Drug-Related Ectopic Pregnancy Safety Signals: FAERS Study

A pharmacovigilance study analyzing FDA adverse event reports from 2004 to 2024 identified 4,924 ectopic pregnancy reports. Levonorgestrel, etonogestrel, and clomifene showed the strongest disproportionate reporting signals, while 16 drugs emerged as potential novel safety signals. These findings may guide further drug-safety research but do not establish causation or confirm increased ectopic pregnancy risk.

Trial finds ex utero cord blood collection comparable to standard collection in weight, cellular composition, and contamination.

Ex Utero vs In Utero Umbilical Cord Blood Collection

A randomized clinical trial involving 101 umbilical cord blood collections found that ex utero collection, performed after placental delivery, was non-inferior to standard in utero collection in terms of blood unit weight. Cellular composition and bacterial contamination rates were also comparable, supporting ex utero collection as a clinically viable alternative that may improve maternal comfort during childbirth and facilitate cord blood donation.

Study links prior concussion to persistent choice reaction-time slowing in collegiate athletes, despite adjusted cognitive scores.

Concussion History and Reaction Time in Collegiate Athletes

A study of 547 NCAA Division I athletes found that those with a history of concussion had significantly slower choice reaction times than matched controls, even after adjusting for memory, concentration, and cognitive performance. No significant differences were observed in simple reaction time, Stroop reaction time, or shifting-attention reaction time, suggesting that choice reaction time may help detect subtle, persistent neurocognitive deficits after concussion.

Study highlights sexual health disparities among transgender individuals, emphasizing inclusive care and policies addressing stigma.

Sexual Health and Vulnerability Among Transgender Individuals

A cross-sectional study of 74 transgender individuals in São Paulo, Brazil, found differences in relationship status, sexual partnerships, and sex work between trans women and trans men. Trans women were more frequently single (76% vs 44.9%) and more likely to report sex work (21.7% vs 6.3%). The findings highlight the need for inclusive sexual health services and policies addressing stigma and structural inequalities.

Meta-analysis links tumor budding to poorer survival in endometrial cancer, highlighting the need for further validation.

Tumor Budding as a Prognostic Marker in Endometrial Cancer

A systematic review and meta-analysis of 10 studies involving 1,307 patients found that tumor budding was associated with poorer progression-free survival (HR 2.44) and overall survival (HR 1.89) in endometrial cancer. However, evidence linking tumor budding to lymph node metastasis was inconsistent. Standardized assessment and validation in larger, molecularly stratified studies are needed to establish its prognostic value.

Nebulized Antibiotics for...

Nebulized Antibiotics for Healthcare- and Ventilator-Associated Pneumonia