The study evaluated a post-anesthesia care unit (PACU) extended-stay model (Grey Zone model) for high-risk adenotonsillectomy patients and assessed the correlation between post-tonsillectomy respiratory compromise and the need for respiratory support during an extended stay at PACU. The Grey Zone model was found to accurately identify patients requiring ICU-level care following adenotonsillectomy, allowing for a safe reduction in the utilization of ICU resources. Overnight observation is recommended due to rare delayed respiratory events. The study found comorbidities associated with a need for intensive care after extended observation, such as neuromuscular disease, chronic lung disease, seizure disorder, and gastrostomy-tube status.

Grey Zone Model for High-Risk Adenotonsillectomy Patients: Correlation between Post-Tonsillectomy Respiratory Compromise and ICU-Level Care Needs

GENERAL MEDICINE

Study highlights gaps in physical activity, sleep and sedentary behavior among adults with intellectual disabilities and caregivers.

Physical Activity, Sleep and Sedentary Time in Adults With ID

A Canadian study of 39 adults with intellectual disabilities, 127 family caregivers and 116 service providers found substantial variation in physical activity, sleep and sedentary time. Walking was the most common activity, with 63.8% meeting activity guidelines when walking was included, but only 25% when excluded. Sleep quality concerns were also common across all groups.

PEDIATRICS

NEUROLOGY

The SAGE framework aims to improve consistent, personalised use of Objects of Reference for people with profound disabilities.

SAGE Framework Improves Object-Based Communication in Disabilities

A practitioner-led study involving 54 family members and practitioners found that Objects of Reference can support communication for children and young people with profound and multiple learning disabilities, but inconsistent use and misunderstanding can limit their value. The study introduces “Individual OoR” and the SAGE framework to promote more consistent, personalised communication.

Study suggests engagement may provide a context-sensitive alternative to traditional assessment for learners with profound disabilities.

Engagement-Based Assessment for Learners With Profound Disabilities

A mixed-methods observational study of six learners with profound and multiple learning disabilities found that engagement can provide meaningful insight into participation, readiness and environmental fit. Four dimensions emerged: relational safety, supported autonomy, regulation through disengagement and re-engagement, and interpretive assessment. Autonomy- and relationship-focused settings supported more sustained engagement.

Microsurgery significantly improved voice quality in patients with lipoid proteinosis, with benefits sustained for 2 years.

Microsurgery Improves Voice Outcomes in Lipoid Proteinosis

A retrospective study of 46 patients with lipoid proteinosis found that all developed hoarseness before age 5, commonly due to diffuse yellowish deposits on the vocal folds. Microsurgical treatment significantly improved voice quality and patient-reported outcomes, with benefits reaching 100% at 1 year and remaining stable at 2 years. Selected patients also benefited from vocal fold fat injection.

UROLOGY

Review links psychostimulant exposure to hormonal disruption, testicular injury and impaired sperm quality and fertility.

Psychostimulants and Male Fertility: Effects on Sperm Health

A review of experimental and clinical evidence suggests that psychostimulants—including cocaine, methamphetamine, methylphenidate, nicotine and caffeine—can disrupt male reproductive function through hormonal imbalance, oxidative stress, testicular injury and epigenetic changes. Reported effects include reduced testosterone, sperm concentration and motility, abnormal morphology and increased DNA fragmentation, highlighting the need for fertility counseling and monitoring.

Six serum metabolites may help predict dapoxetine response and support personalized treatment strategies for premature ejaculation.

Serum Metabolites Predict Dapoxetine Response in Premature Ejaculation

A metabolomics study of 116 men with lifelong premature ejaculation identified six serum metabolites associated with response to 8 weeks of dapoxetine treatment. Combining these metabolites improved prediction accuracy from 0.738 to 0.892 (p=0.001). Most differential metabolites were linked to arachidonic acid metabolism, suggesting potential biomarkers for personalized PE treatment.

RHEUMATOLOGY

Global experts and patients propose 39 items for a revised lupus damage index to improve assessment of SLE-related damage.

Revised SLE Damage Index: 39 Items Proposed by Global Experts

An international SLE initiative supported by SLICC, ACR and the Lupus Foundation of America has proposed a revised Systemic Lupus Damage Index. Input from 146 experts and patients across 35 countries reduced 2,256 nominated items to 39 candidate items across 13 domains. Several original items were removed and new measures, including growth failure and adrenal insufficiency, were proposed.

ACDF may increase OSA risk and respiratory complications, highlighting the need for screening and individualized perioperative care.

ACDF Linked to OSA Risk and Postoperative Respiratory Complications

A scoping review of 12 studies found that anterior cervical discectomy and fusion (ACDF) may trigger new-onset or worsen existing obstructive sleep apnea (OSA). Patients with OSA had more postoperative respiratory complications, greater need for mechanical ventilation and longer hospital stays. Researchers call for routine OSA screening and individualized perioperative care.

Study finds subtle Doppler changes in late-onset FGR, suggesting cardiac hemodynamic alterations with advanced placental compromise.

Doppler Study Explores Cardiac Hemodynamics in Fetal Growth Restriction

<a href="/toc/iA prospective study of 80 pregnancies found no significant overall differences in Doppler-estimated fetal interatrial pressure gradients between late-onset fetal growth restriction (FGR) and controls. However, pulmonary vein D-wave velocity was reduced in FGR, while markedly lower gradients appeared in fetuses with elevated umbilical artery resistance, suggesting hemodynamic changes may emerge with advanced placental compromise.jmf20/39/1">Volume 39, Issue 1</a>, December 2026<br />. <br />

PSYCHIATRY

Experts highlight limits of youth mental health diagnoses and support stepped care based on severity and individual needs.

Rethinking Mental Health Diagnoses in Children and Adolescents

Mental health diagnoses help guide communication, treatment and prognosis in children and adolescents, but experts highlight important limitations. Diagnoses often represent symptom-based syndromes rather than distinct biological conditions, with substantial overlap, developmental changes and severity across a spectrum. The perspective supports stepped care tailored to individual needs rather than diagnosis alone.

ORTHOPAEDICS

Seven years after MLKI surgery, many patients had persistent strength and functional deficits, especially after bicruciate injuries.

Long-Term Muscle Deficits After Multiligament Knee Injury Surgery

A 7-year follow-up study of 90 patients surgically treated for multiligament knee injuries found persistent muscle and functional deficits. More than half had not regained full quadriceps strength, while 46% had hamstring deficits. Nearly half failed the 90% symmetry threshold on single-leg hop testing, with greater deficits seen after bicruciate injuries.

ENDO-DIABETOLOGY

GLP-1 therapy was linked to a modest increase in laryngeal symptoms, including cough and voice disorders, in a large U.S. study.

GLP-1 Drugs Linked to Increased Laryngeal Symptoms

A large U.S. cohort study of more than 4.1 million adults found that GLP-1 receptor agonist therapy was associated with a modestly higher risk of laryngeal symptoms within six months, particularly cough, foreign-body sensation, and voice or resonance disorders. Researchers note that absolute risk increases were small but may be clinically relevant given widespread GLP-1 use.

DENTISTRY

ONCOLOGY

A margin-to-depth ratio below 0.5 may identify higher-risk oral cancer patients and guide postoperative radiotherapy.

Margin-to-Depth Ratio May Improve Oral Cancer Risk Assessment

A combined analysis of more than 8,300 patients with oral squamous cell carcinoma found that the ratio of surgical margin to tumor depth may better predict recurrence than a fixed 5-mm margin. A ratio below 0.5 was linked to poorer disease-free survival and identified patients who may benefit from postoperative radiotherapy.

CRITICAL CARE

PULMONOLOGY

EMERGENCY MEDICINE

Rapidly improving respiratory failure was linked to lower mortality, more ventilator-free days and reduced inflammatory biomarkers.

Rapidly Improving Respiratory Failure Linked to Lower ICU Mortality

A retrospective study found that 61% of mechanically ventilated patients with acute hypoxemic respiratory failure achieved minimal ventilator support within 24 hours. This rapidly improving group had substantially lower 90-day mortality (22% vs 49%), more ventilator-free days, and lower inflammatory biomarkers, suggesting a distinct hypo-inflammatory phenotype.

Higher CSF fibrinogen was linked to inflammation and faster tau accumulation in cognitively unimpaired older adults.

Fibrinogen Linked to Faster Tau Accumulation in Preclinical Alzheimer’s

A study of cognitively unimpaired older adults found that higher cerebrospinal fluid fibrinogen levels were associated with glial inflammation and predicted faster accumulation of phosphorylated tau over 2.5 years. The findings suggest that blood–brain barrier dysfunction may contribute to early Alzheimer’s disease progression before cognitive symptoms emerge.

Review of the Utility of ...

Review of the Utility of Extended Recovery Room Observation after Adenotonsillectomy