DERMATOLOGY

A Case of alopecia areata showing relapse during tofacitinib treatment, managed with corticosteroids and switch to ritlecitinib, revealing JAK inhibitor limitations and pathogenesis insights.

JAK Inhibitor Failure and Switch Strategy in Alopecia Areata

A 26-year-old patient with alopecia areata initially responded to tofacitinib but developed relapses during treatment. Corticosteroids controlled the flare-ups, and the patient was eventually transitioned to ritlecitinib. This case highlights the limitations of JAK inhibitor monotherapy and suggests that combination strategies or alternative agents may be needed. It also underscores the complex pathogenesis of AA beyond the JAK–STAT pathway.

Dysphagia affected 63.3% after modified UPPP, with GERD, female sex, psychological factors and sleepiness increasing risk.

Dysphagia Risk After Surgery for Obstructive Sleep Apnea

A prospective study of 120 patients undergoing modified uvulopalatopharyngoplasty found clinically significant dysphagia in 63.3% at 2 weeks, with abnormalities confirmed by FEES in over 94% of symptomatic patients. Female sex, GERD, anxiety/depression, and excessive daytime sleepiness independently increased risk, while 9.2% remained symptomatic at 12 months.

PSYCHIATRY

Persistent youth irritability was linked to higher risks of depression, anxiety, suicidal ideation and self-injury by age 21.

Youth Irritability Patterns Predict Later Mental Health Risk

A longitudinal study of 532 young people found that tonic and phasic irritability follow distinct but linked developmental paths from ages 12 to 21. Persistent, mood-based irritability increased modestly and was associated with higher risks of depression, anxiety, suicidal ideation, suicidal acts, and self-injury, while episodic outbursts showed different psychiatric associations.

Type II thyroplasty with titanium bridges provides durable voice improvement and low revision rates in spasmodic dysphonia.

Titanium Thyroplasty Offers Durable Voice Improvement

A scoping review of 15 studies found that Type II thyroplasty using titanium bridges can provide substantial and durable voice improvement in adductor spasmodic dysphonia. Voice Handicap Index scores improved markedly, with benefits lasting up to 8.4 years. Revision rates were 2%–7%, while complications were generally minor and transient.

Poorer pretreatment quality of life was associated with higher mortality in head and neck cancer, supporting early supportive care.

Pretreatment Quality of Life Linked to Cancer Survival

A meta-analysis of 32 independent studies found that poorer pretreatment health-related quality of life was associated with higher mortality in head and neck cancer. Global quality of life and physical, role, and social functioning showed the most consistent associations, highlighting the potential value of early supportive-care assessment before treatment.

Routine umbo resection may not be necessary in tympanoplasty when meticulous de-epithelialisation is achieved.

Routine Umbo Resection May Not Be Needed in Tympanoplasty

A prospective cohort study of 148 Type I over–underlay tympanoplasties found epithelial remnants in some patients, particularly when perforations involved the umbo, but no postoperative cholesteatoma occurred during 24 months of follow-up. The findings suggest routine umbo resection may be unnecessary when meticulous de-epithelialisation is possible, supporting selective resection based on intraoperative findings.

UROLOGY

Smokeless tobacco use was linked to poorer sperm quality, including reduced motility, concentration and vitality in men.

Smokeless Tobacco Linked to Male Infertility Risk

A systematic review and meta-analysis of 16 studies involving 3,401 men found that smokeless tobacco use was associated with lower sperm motility, concentration and vitality, along with more abnormal sperm morphology. The findings identify smokeless tobacco as a potentially overlooked risk factor for male infertility and support screening for its use during infertility evaluations.

TAS2R genetic variants were linked to chronic rhinosinusitis risk, with associations predominantly observed among women.

TAS2R Variants Linked to Chronic Rhinosinusitis Risk

A large East Asian genetic study involving 826 patients with chronic rhinosinusitis and 8,260 controls found that variants in TAS2R38 and TAS2R42 increased CRS risk, while a TAS2R1 variant appeared protective. The associations were strongly female-driven, highlighting potential sex-specific genetic pathways for CRS and precision treatment.

Dupilumab restored CLDN10 and nasal epithelial barrier function disrupted by IL-13 in chronic rhinosinusitis with nasal polyps.

Dupilumab Restores Nasal Barrier Function in CRSwNP

New research identifies IL-13-driven loss of claudin-10 (CLDN10) as a key mechanism behind nasal epithelial barrier disruption in chronic rhinosinusitis with nasal polyps. In laboratory models, dupilumab restored CLDN10 expression and barrier function while reducing epithelial remodeling and inflammatory signals, supporting CLDN10 as a potential therapeutic target.

Sinonasal disease persisted in many EGPA patients despite systemic remission with mepolizumab, supporting integrated ENT management.

Sinonasal Disease Persists in EGPA Despite Mepolizumab

A 24-month real-world study of 52 patients with eosinophilic granulomatosis with polyangiitis found that mepolizumab achieved systemic remission in more than 90% of patients, but sinonasal disease often persisted. Polyps remained in 64% and mucosal edema or discharge in 92%, highlighting the need for dedicated ENT assessment and integrated biologic–surgical management.

Temperature-controlled radiofrequency matched surgery for nasal obstruction, with fewer adverse events and faster return to activities.

Radiofrequency Treatment Comparable to Surgery for Nasal Obstruction

A prospective trial across 29 US sites found temperature-controlled radiofrequency (TCRF) treatment was non-inferior to septoplasty and functional rhinoplasty for nasal airway obstruction and nasal valve dysfunction. At 3 months, response rates exceeded 90%, while TCRF was associated with faster return to normal activities and fewer adverse events than surgery.

Meaningful smell recovery remained possible even when treatment for COVID-19-related smell loss began more than 2 years later.

Smell Recovery Possible Years After COVID-19-Related Loss

A retrospective study of 104 patients found that people with long-standing COVID-19-related smell loss could still achieve clinically meaningful recovery after delayed treatment. Among 47 patients with COVID-19-related smell loss, TDI scores improved significantly, with 46% achieving the predefined clinically important improvement. Even when treatment began more than 2 years after onset, 50% achieved meaningful recovery.

GYNAECOLOGY - IVF

Cell-free DNA enrichment improved low-depth NIPT performance for fetal CNV detection, with higher fetal fractions improving breakpoint accuracy.

Low-Depth NIPT Improves Detection of Fetal CNVs

A large retrospective study of 86,012 pregnancies found that low-depth NIPT using cell-free DNA enrichment detected fetal copy number variations with a 59.2% overall positive predictive value. Higher fetal fractions improved CNV breakpoint accuracy, suggesting enrichment may enhance NIPT performance without relying solely on increased sequencing depth.

NEUROLOGY

Surrogate-assisted CFD optimization reduced hemolysis, platelet activation and torque in a ventricular assist device rotor design.

AI-Assisted VAD Rotor Optimization Reduces Blood Damage

A surrogate-assisted optimization workflow using 4,809 CFD simulations identified ventricular assist device rotor designs that balance hydraulic performance with blood compatibility. Direct CFD validation of a representative design showed 55.6% lower hemolysis, 46.9% lower platelet activation, 27.0% shorter exposure time, and 17.2% lower torque, while low-shear fraction improved by 4.5%.

PEDIATRICS

Pediatric sleep apnea often presents with restless sleep and neurocognitive symptoms rather than classic snoring or sleepiness.

Pediatric Sleep Apnea Often Differs From Adult Presentations

A cohort study of 491 children evaluated for pediatric obstructive sleep apnea found that restlessness, insomnia, kicking legs, and frequent awakening were more common than snoring. Nearly 94% had neurocognitive issues, while only 13.2% reported significant daytime sleepiness. PAP therapy produced greater neurocognitive improvement than adenotonsillectomy, with nearly fourfold higher adjusted odds of improvement.

HFOV-VG amplitude variability may help predict adverse respiratory outcomes in preterm infants.

HFOV-VG Amplitude Variability May Predict Respiratory Outcomes

A retrospective study of 60 preterm infants found that oscillatory amplitude variability during high-frequency oscillatory ventilation with volume guarantee (HFOV-VG) declined over the first 72 hours. Higher within-infant oscillatory frequency was linked to greater variability, while higher mean airway pressure was associated with lower variability. Early variability showed moderate predictive ability for death or moderate-to-severe bronchopulmonary dysplasia, with an AUC of 0.72, rising to 0.82 when combined with frequency and weight-normalised DCO₂.

Secondary Failure of Tofa...

Secondary Failure of Tofacitinib in Alopecia Areata Management