What’s new in medical literature
What's new in the medical literature?
Updated 10 April 2025
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New ASRA guidelines for regional anesthesia in patients taking anticoagulants
The American Society of Regional Anesthesia and Pain Medicine (ASRA) has published updated guidelines for regional anesthesia in patients receiving antithrombotic or thrombolytic therapy [9]. Important changes from the prior edition include new recommendations on timing of needle placement or catheter removal for direct oral anticoagulants and fondaparinux, designation of high versus low doses for some medications, and new guidance on plasma levels of medications that should be used to determine whether regional anesthesia techniques are appropriate. Our recommendations are consistent with these guidelines and are shown in a table (table 1). (See "Neuraxial anesthesia/analgesia techniques in the patient receiving anticoagulant or antiplatelet medication".)
Predictors of lung injury after pediatric drowning
Children with nonfatal drowning often develop lung injury and require respiratory support; however, it is often difficult to determine the appropriate disposition for children with less severe presentations at initial evaluation in the emergency department (ED). In a multicenter, retrospective study of over 4200 children seen in a pediatric ED after drowning, risk factors associated with clinically significant lung injury included age >5 years, submersion duration >5 minutes, any resuscitation at the scene or during the ED evaluation, altered mental status or abnormal heart rate, respiratory rate, or lung auscultation. [8]. These findings provide guidance on which children who are not obviously critically ill following drowning may need admission for respiratory monitoring. (See "Drowning (submersion injuries)", section on 'Hypoxic and other severely ill patients'.)
Red blood cell transfusion in patients with acute coronary syndromes
Previous evidence suggests a possible benefit with use of a liberal red blood cell transfusion threshold (hemoglobin <10g/dL) in patients with acute myocardial infarction (MI). In a recently published meta-analysis of over 4300 patients from four trials, patients randomly assigned to a liberal or restrictive (hemoglobin <7 to 8 g/dL) transfusion threshold had similar rates of mortality and recurrent MI after 30 days [11]. In patients with acute MI and anemia who do not have signs of shock, ongoing ischemia, blood loss, or symptoms of anemia, the approach to transfusion is individualized. (See "Overview of the acute management of non-ST-elevation acute coronary syndromes", section on 'Anemia'.)
Role of urodynamic testing in evaluating female urinary incontinence
While urodynamic testing has no role in the initial evaluation of females with stress urinary incontinence, studies continue to evaluate its utility in the initial evaluation of females with urgency or mixed urinary incontinence. In a multicenter trial of 1099 female patients with refractory overactive bladder or urgency-predominant mixed urinary incontinence, 15-month treatment success rates were similar whether the treatment was based on urodynamics with clinical assessment or clinical assessment alone [22]. These findings support our practice of not performing urodynamic testing in the initial evaluation of urinary incontinence in female patients whose symptoms are consistent with stress, urgency, or mixed urinary incontinence. (See "Female urinary incontinence: Evaluation", section on 'Clinical tests, including urodynamic testing'.)
Sex differences in ankylosing spondyloarthritis
Whether sex impacts outcomes among patients with ankylosing spondylitis (AS) has been unclear. A meta-analysis of 22 trials including 7331 patients with AS demonstrated that male patients were more likely to respond to either biologic or targeted synthetic disease-modifying antirheumatic drugs than female patients (odds ratio [OR] 1.88) [9]. This same observation was made when the analysis was restricted to tumor necrosis factor inhibitors (OR 2.42) or interleukin-17A inhibitors (OR 1.82). These findings may reflect that, compared with male patients with AS, female patients have longer delays in diagnosis, higher pain scores, and more peripheral arthritis, all of which correlate with worse treatment outcomes. (See "Treatment of axial spondyloarthritis (ankylosing spondylitis and nonradiographic axial spondyloarthritis) in adults", section on 'Prognostic indicators'.)
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Closure of mesenteric defects for prevention of internal hernia after Roux‐en‐Y gastric bypass in bariatric surgery Cochrane Library 8 April 2025
The closure of defects may be more effective than the non‐closure of defects for prevention of internal hernia after RYGB. However, the small number of trials limited our confidence in the evidence. There is little to no difference between the closure and non‐closure of defects in the incidence of postoperative overall complications, the incidence of postoperative mortality, and the incidence of intraoperative overall complications. The length of hospital stay may be longer for those undergoing defect closure than for those who did not have the defects closed. The evidence is very uncertain about the incidence of postoperative mortality, the incidence of intraoperative overall complications, and the length of hospital stay. Additional evidence based on trials designed to be at low risk of bias and with an adequate sample size is imperative.
Effect of adrenergic agonist oral decongestants on blood pressure Cochrane Library 27 March 2025
In this systematic review, chronic daily intake of adrenergic agonist oral decongestants had little to no effect on blood pressure, heart rate, and withdrawals due to adverse effects. People making decisions about using these medicines should consider the very low certainty of evidence and the theoretical risk of increased blood pressure. Independent trials free from biases that are designed to answer this question are required. The evidence was limited due to the small number of studies, and the blood pressure and heart rate not being measured at the optimal time after drug ingestion.
Effect of amphetamines on blood pressure Cochrane Library 28 March 2025
Daily oral amphetamines increase blood pressure, heart rate, and withdrawals due to adverse effects, with these effects observed across all time points, including shorter (≤ four weeks) and longer durations (> four weeks to < eight weeks; ≥ eight weeks) of use. Future trials should measure blood pressure using 24‐hour ambulatory monitoring and assess the effect of long‐term use.
Digital tracking, provider decision support systems, and targeted client communication via mobile devices to improve primary health care Cochrane Library 7 April 2025
Digital tracking may improve primary care workers' ability to follow recommended antenatal and chronic disease practices, quality of patient records, patient health outcomes and service use. However, these interventions led to small or no outcome differences in most studies.
Gonadotropins for ovulation induction in women with polycystic ovary syndrome Cochrane Library 7 April 2025
There may be little or no difference in live birth, multiple pregnancy, clinical pregnancy, or miscarriage rates between rFSH and uFSH in women with PCOS. For HMG versus uFSH, we are uncertain whether one or the other improves or lowers rates of live birth, multiple pregnancy, clinical pregnancy, or miscarriage. We are uncertain whether any of the interventions reduce ectopic pregnancy or the incidence of OHSS. In women with clomiphene citrate failure, gonadotropins (FSH) probably result in more live births and clinical pregnancies than continued clomiphene citrate without increasing multiple pregnancies. Gonadotropins may increase the miscarriage rate per woman. We are uncertain if gonadotropins reduce ectopic pregnancy. None of the women developed OHSS.
Delayed initiation or reduced initial dose of calcineurin‐inhibitors for kidney transplant recipients at high risk of delayed graft function Cochrane Library 8 April 2025
There may be little or no difference in delayed graft function (DGF) or acute rejection when delaying the start of calcineurin inhibitors (CNI) or when starting it at a lower dose in kidney transplant recipients at high risk of DGF. The available data are of low certainty.
Drug treatment for myotonia Cochrane Library 8 April 2025
More‐recent trials are more robust, and well‐conducted RCTs demonstrate moderate‐certainty evidence for the efficacy of symptomatic treatments in non‐dystrophic myotonias. Additionally, the data suggest that not all patients respond to therapy and research into aetiology and treatment options for non‐responders is needed. Other agents that have not been tested in RCTs, such as acetazolamide, flecainide, ranolazine, and lacosamide, will need to be considered when planning future clinical trials. Moreover, the RCTs, in particular the small numbers of most trials, highlight the challenges in recruitment and design of robust trials in rare diseases, and research into trial design to improve recruitment in rare diseases will be important for future trials.
Non‐pharmacological and non‐surgical treatments for low back pain in adults: an overview of Cochrane reviews Cochrane Library 27 March 2025
Spinal manipulation probably makes no difference to function compared to placebo for people with acute/subacute LBP. Acupuncture probably improves function slightly for people with chronic LBP, compared to sham acupuncture. There is probably no difference between traction and sham traction for pain intensity in people with chronic LBP. Compared to advice to rest, advice to stay active probably reduces pain intensity slightly and improves function slightly for people with acute LBP. Acupuncture probably reduces pain intensity, and improves function slightly for people with chronic LBP, compared to no treatment. Acupuncture probably improves function slightly for people with chronic LBP, compared to usual care. Exercise therapies probably reduce pain intensity, and improve function slightly for people with chronic LBP, compared to no treatment/usual care. Multidisciplinary therapies probably reduce pain intensity, and improve function slightly for people with chronic LBP, compared to usual care. Compared to usual care, psychological therapies probably reduce pain intensity slightly, but probably make no difference to function for people with chronic LBP.
Preoperative medical therapy before surgery for uterine fibroids Cochrane Library 4 April 2025
Pretreatment with gonadotropin‐hormone‐releasing analogues may reduce uterine and fibroid volume and probably increases preoperative haemoglobin levels, but probably also increases the number of adverse events. Blood transfusions and operation time during hysterectomy may be reduced, with fewer women experiencing postoperative morbidity. SPRMs, such as ulipristal acetate, seem to offer similar advantages: they probably reduce uterine volume and increase haemoglobin level before surgery, and may reduce fibroid volume and fibroid‐related bleeding. However, replication of these studies is advised as the certainty of the evidence is moderate to low.
Stem cell injections for osteoarthritis of the knee Cochrane Library 2 April 2025
Compared with placebo injections and based upon low‐certainty evidence, stem cell injections for people with knee osteoarthritis may slightly improve pain and function. We are uncertain of the effects of stem cell injections on quality of life or the number who report treatment success. Although the putative benefits of stem cell therapies for osteoarthritis include potential regenerative effects on damaged tissues, particularly articular cartilage, we remain uncertain of the effect of stem cell injections on structural progression in the knee (measured by radiographic appearance). There is also uncertainty regarding the safety of stem cell injections. Serious adverse events were infrequently reported, although all invasive joint procedures (including injections) carry a small risk of septic arthritis. The risk of other important harms, including potential concerns related to the use of a therapy with the theoretical capacity to promote cell growth, or to the use of allogeneic cells, remains unknown.
Transversus abdominis plane (TAP) blocks for prevention of postoperative pain in women undergoing laparoscopic and robotic gynaecological surgery Cochrane Library 3 April 2025
Amongst women undergoing minimally invasive gynaecologic surgery, we did not find a clinically meaningful effect of TAP block on postoperative pain or opioid consumption. However, there may be a small reduction of pain using TAP blocks compared to local anaesthetic or sham blocks. The TAP block is probably safe, since no adverse events were noted amongst the 525 women who received a block, and for whom safety data were available. The evidence is limited by heterogeneity in the results, risk of bias in the studies, and assumptions made for synthesis when combining data.
Ultrasound‐guided versus anatomic landmark‐guided percutaneous femoral artery access Cochrane Library 28 March 2025
Ultrasound guidance may confer clinical benefit over anatomic landmark guidance for percutaneous CFA access regarding first‐pass success, time to successful CFA access, and unintentional venipuncture, without increasing the risk of adverse events. Evidence for other outcomes including major bleeding, overall cannulation success, number of access attempts, retroperitoneal hematoma, minor bleeding, pseudoaneurysms, arterial dissection, arteriovenous fistulae, arterial occlusion, infection, or pain scores demonstrates no benefit to ultrasound guidance over anatomic landmark guidance. Data on higher‐risk subgroups, including people with elevated BMI, extensive atherosclerosis or calcification, and high femoral artery bifurcation, are lacking. Generalizability was also limited by the high risk of bias across most studies and the exclusion of important subgroups (e.g. people with non‐palpable pulses).
Withdrawal of antihypertensive drugs in older people Cochrane Library 31 March 2025
The main conclusions from the 2020 review still apply. Discontinuing antihypertensives may result in little to no difference in mortality, hospitalisation, and stroke. The evidence is very uncertain about the effect of discontinuing antihypertensives on myocardial infarction and adverse drug reactions and adverse drug withdrawal reactions. Discontinuing antihypertensives may result in an increase in blood pressure. There was no information about the effect on falls. The evidence was of low to very low certainty, mainly due to small studies and low event rates. These limitations mean that we cannot draw any firm conclusions about the effect of deprescribing antihypertensives on these outcomes. Future research should focus on populations with the greatest uncertainty of the benefit:risk ratio for the use of antihypertensive medications, such as those with frailty, older age groups, and those taking polypharmacy, and measure clinically important outcomes such as adverse drug events, falls, and quality of life.
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Social determinants of health and intensive care unit admission rates and outcomes for children, Australia, 2013–2020: analysis of national registry data MJA 8 April 2025
- The known: Social determinants of health, such as socio-economic status, influence outcomes for people admitted to intensive care units (ICUs). Their influence on admission rates and survival for Australian children has not been investigated using registry data.
- The new: Population-standardised ICU admission rates are higher for Indigenous children and children in areas of socio-economic disadvantage. Raw mortality during ICU admission is also higher for both groups, but the difference is statistically significant only for socio-economic status after adjusting for pre-illness, admission, and hospital factors.
- The implications: Targeted interventions based on further research are needed to reduce differences associated with social determinants of health. MJA 8 April 2025
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Addressing allergy gaps in rural Australia MJA insight 7 April 2025
A new national online service aims to equip rural doctors with support, education and advice from clinical immunology and allergy specialists.
Bacterial vaginosis: bringing male partners into the equation MJA insight 31 March 2025
New research has found bacterial vaginosis is sexually transmitted, and male partners can help in limiting recurrence of the condition.
Foreign aid cuts could mean 10 million more HIV infections by 2030 – and almost 3 million extra deaths MJA insight 7 April 2025
In January, the Trump administration ordered a broad pause on all US funding for foreign aid. Among other issues, this has significant effects on US funding for HIV. The United States has been the world’s biggest donor to international HIV assistance, providing 73% of funding in 2023. A large part of this is the US President’s Emergency Plan for AIDS Relief (PEPFAR), which oversees programs in low- and middle-income countries to prevent, diagnose and treat the virus. These programs have been significantly disrupted.
Global health leaders urge Australia to stand up to the USA MJA insight 7 April 2025
One of the world’s foremost global health policy thought leaders, Nina Schwalbe, has urged Australians to join the fight against the withdrawal of United States funding for global health aid.
Guidelines for including people with vision impairment in clinical research MJA insight 31 March 2025
People with vision impairment face unique barriers when it comes to participating in clinical research and accessing health information. Around 800 000 Australians are living with some form of vision impairment, with inherited retinal diseases (IRDs) being the leading cause in working-age adults. Including lived experience in health research is crucial for ensuring that health care meets the needs of the individuals requiring care, but people with vision impairment face significant barriers to accessing health information.
Indigenous people need culturally tailored programs to combat type 2 diabetes MJA insight 31 March 2025
A new systematic review finds tailored, culturally appropriate programs are the key to better outcomes, and Australia needs more of these programs to prevent and manage type 2 diabetes among Indigenous youth.
International partnership develops new guidelines and resources for premature ovarian insufficiency MJA insight 31 March 2025
Premature ovarian insufficiency has life-altering impacts on women’s psychological and physical health and can be challenging for clinicians. New guidelines have been developed to help clinicians apply best practice care for women experiencing this condition.
“The next five years are pivotal” – MJA–Lancet countdown on health and climate finds progress still lacking MJA insight 7 April 2025
The MJA–Lancet countdown shows that Australia is more engaged with the health impacts of climate change, but greater efforts to reduce our dependency on fossil fuels are urgently needed.
Vaccines under attack MJA insight 7 April 2025
Immunisation with life-saving vaccines is one of the greatest achievements in public health, but a growing wave of misinformation/disinformation in the wake of the COVID-19 pandemic threatens to undermine the many successes of vaccination.
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Caring for patients experiencing homelessness BMJ 31 March 2025
What you need to know
- People experiencing homelessness face multiple barriers to accessing health care and have high mortality and morbidity from preventable or treatable conditions
- Clinicians should consider preventive care, harm reduction, and the increased rates of multimorbidity and early onset frailty when caring for people experiencing homelessness
- Trauma informed practice provides a framework to enable respectful, safe, collaborative, and empowering relationships
Evaluating patients with chest pain in the emergency department BMJ 28 March 2025
Identifying patients with chest pain that is of cardiac origin is crucial owing to the high mortality and morbidity of cardiovascular diseases. History, electrocardiogram, and cardiac biomarkers are the core elements of the assessment. High sensitivity cardiac troponins (hs-cTn) are the preferred biomarkers for diagnosing acute myocardial infarction, allowing for more accurate detection and exclusion of myocardial injury. However, elevations in hs-cTn can occur in patients who are not experiencing acute myocardial infarction. Therefore, it is important for clinicians to recognize how to integrate hs-cTn levels into their clinical decision making process. Structured risk assessments, using evidence based diagnostic protocols, should be employed to estimate the risk of acute coronary syndrome and adverse events in patients with chest pain. Clinical decision pathways should be used routinely in emergency departments. Patients at intermediate or high risk of obstructive coronary artery disease might benefit from cardiac imaging and further testing. Patients should be involved in decision making, with information provided about risks, radiation exposure, costs, and alternative options to facilitate informed decision making.
Finding the right treatment for severe depression BMJ 2 April 2025
What you need to know:
- Severe depression can appear from nowhere with no previous symptoms, leaving patients confused, frightened, and lost
- When discussing a diagnosis of severe depression, help the person to understand that treatment may be complex and that it might take time to find the right approach
- Having an open conversation about the potential for relapse can help patients understand the importance of continuing treatment
Schoolchildren with asthma face different risks at different ages BMJ 3 April 2025
The study found that:
- Children aged 5 to 8 years were most likely to have an asthma attack (14% of these children had an attack in every whole year, compared with 7% among those aged 12 to 16 years)
- Delayed diagnosis was most common in the youngest children
- Young people aged 12 to 16 years were least likely to receive both long-acting preventers and short-acting relievers; 1 in 5 used short-acting relievers only for two years.
- For children of all ages, being from a more deprived area and having a delayed diagnosis increased the risk of an asthma attack. Other risk factors varied with age. Compared with the other age groups:
- Children aged 5 to 8 years were more likely to have an asthma attack if they were male, or had eczema or food and drug allergies
- Those aged 9 and above were more likely to have an asthma attack if they were obese or allergic to air particles.
In further research among children with asthma, the same team found that less than half received the recommended asthma reviews, inhaler technique checks, and asthma management plans. Children who received all of these interventions had a reduced chance of an asthma exacerbation (reduction of approximately 30% in 12 months).
Stepwise dual antiplatelet therapy de-escalation in patients after drug coated balloon angioplasty (REC-CAGEFREE II): multicentre, randomised, open label, assessor blind, non-inferiority trial BMJ 31 March 2025
Among participants with acute coronary syndrome who could be treated by drug coated balloons exclusively, a stepwise dual antiplatelet therapy (DAPT) de-escalation was non-inferior to 12 month DAPT for net adverse clinical events.
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Antenatal opioid exposure and global and regional brain volumes in newborns JAMA 7 April 2025
In a large cohort of antenatally opioid-exposed newborns, there were significant reductions in global and regional brain volumes compared to unexposed controls. These data suggest vulnerability of the developing brain to antenatal opioid exposure, with varying effects depending on the type and number of substances.
Automating the addiction behaviors checklist for problematic opioid use identification JAMA 9 April 2025
This automated data extraction technique may facilitate earlier identification of people at risk for and who are experiencing problematic opioid use, and create new opportunities for studying long-term sequelae of opioid pain management.
Clinician suicide risk assessment for prediction of suicide attempt in a large health care system JAMA 9 April 2025
Clinicians stratify patients for suicide risk at levels significantly above chance. However, the predictive accuracy improves significantly by statistically incorporating information about recent suicidal thoughts and behaviors and other factors routinely assessed during clinical suicide risk assessment.
GLP-1RA and SGLT2i medications for Type 2 Diabetes and Alzheimer Disease and related Dementias JAMA 7 April 2025
In people with T2D, both glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) were statistically significantly associated with decreased risk of Alzheimer disease and related dementias (ADRD) compared with other glucose-lowering drugs (GLD)s, and no difference was observed between both drugs
Hypertensive disorders of pregnancy and long-term risk of dilated cardiomyopathy JAMA 2 April 2025
Long-term clinical vigilance of patients with a history of hypertensive disorders of pregnancy for the development of dilated cardiomyopathy may be warranted.
Mindfulness vs Cognitive Behavioral Therapy for chronic low back pain treated with opioids: A randomized clinical trial JAMA 7 April 2025
Results of the study suggest that both treatments have potential utility in treating adults with refractory chronic low back pain (CLBP) and improving pain, function, and quality-of-life outcomes.
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Dapagliflozin in patients undergoing transcatheter aortic-valve implantation NEJM 29 March 2025
Among older adults with aortic stenosis undergoing TAVI who were at high risk for heart-failure events, dapagliflozin resulted in a significantly lower incidence of death from any cause or worsening of heart failure than standard care alone.
Extended reduced-dose Apixaban for cancer-associated venous thromboembolism NEJM 29 March 2025
Extended anticoagulation with reduced-dose apixaban was noninferior to full-dose apixaban for the prevention of recurrent venous thromboembolism in patients with active cancer. The reduced dose led to a lower incidence of clinically relevant bleeding complications than the full dose.
Global effect of cardiovascular risk factors on lifetime estimates NEJM 30 March 2025
The absence of five classic risk factors at 50 years of age was associated with more than a decade greater life expectancy than the presence of all five risk factors, in both sexes. Persons who modified hypertension and smoking in midlife had the most additional life-years free of cardiovascular disease and death from any cause, respectively.
Otitis Media in young children NEJM 9 April 2025
- Acute otitis media is a bacterial infection that occurs almost exclusively after a viral upper respiratory tract infection.
- Common pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
- Bulging of the tympanic membrane is a defining feature.
- Children with mild or moderate symptoms can be either treated with antibiotic agents or closely observed.
- High-dose amoxicillin (80 to 90 mg per kilogram of body weight per day, divided into two doses) remains the first-line treatment. Amoxicillin–clavulanate therapy warrants consideration in children in whom H. influenzae is likely to predominate (i.e., those who have received antibiotics in the previous 30 days, have conjunctivitis–otitis syndrome, or have spontaneous rupture of the tympanic membrane).
- Treatment with antibiotics for 10 days resulted in less treatment failure and less use of rescue antibiotics than treatment for 5 days.
- Tympanocentesis is indicated in children with acute otitis media who have had treatment failure with multiple rounds of antibiotic therapy.
- Among children with recurrent acute otitis media, the incidence of acute otitis media during a 2-year period was similar among those who had placement of a tympanostomy tube and those who received episodic antibiotic treatment.
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A viro-immunological model to characterize the antiviral effect of molnupiravir in SARS-CoV-2-infected outpatients: implication for treatment duration Journal of infectious diseases 1 April 2025
This model suggests that molnupiravir acts primarily on viral replication, and does not act specifically on viral infectivity. Longer administration of molnupiravir may reduce rebound rate and shorten time to viral clearance.
Bacterial and viral co-infections in adult patients hospitalized with COVID-19 throughout the pandemic: A Multinational Cohort Study in the EuCARE Project Journal of infectious diseases 3 April 2025
Bacterial and viral co-infections were more prevalent during the Omicron period compared with preceding variants. Such co-infections were associated with an increased risk of in-hospital mortality, calling for sustained monitoring and clinical vigilance.
Effectiveness of nurse-led transitional care interventions for adult patients discharged from acute care hospitals: a systematic review and meta-analysis BMC nursing 7 April 2025
Nurse-led transitional care interventions effectively reduced readmission and emergency department visit rates and improved QOL in adult patients discharged from acute care hospitals.
Improvement in quality of life and loneliness after the community connections program: a community-based pilot intervention in South Australia BMC psychology 7 April 2025
Participants of the Community Connections Program (CCP) pilot intervention reported significantly improved quality of life (QoL) and reduced loneliness at program completion. The CCP shows promise for the ability of community-based interventions to reduce loneliness and improve QoL for individuals disconnected from their communities and local health and support care services. These findings have implications for the development of programs that facilitate place-based, person-centered connections as important drivers of public health and wellbeing.
Lived experience participation in suicide prevention activities in Australia: A scoping review Health expectations 5 April 2025
Current processes for reporting experiences of lived experience participation in suicide prevention lack standardisation within peer-reviewed publications. This review notes that there are gaps in the literature; however, the evidence base is growing for research that reports on suicide prevention research and activities that involve people with lived experience.
Mediterranean diet and diabetic microvascular complications: a systematic review and meta-analysis BMC nutrition 2 April 2025
Adherence to the Mediterranean diet is associated with a reduced risk of diabetic nephropathy and retinopathy, supporting its potential as a dietary intervention for diabetes management. However, the evidence for neuropathy remains inconclusive. Future well-controlled randomized trials are needed to strengthen causal inferences and refine clinical recommendations for MD-based interventions in diabetic microvascular complications.
Survivorship in robotic total knee arthroplasty compared with conventional total knee arthroplasty: A systematic review and meta-analysis Arthroplasty 8 April 2025
Conventional TKA is non-inferior to rTKA at short and long-term follow-up with regard to implant survival, complications, and postoperative pain scores, while rTKA shows subtle improvements in functional outcome measures.
The effect of pre-existing coronavirus antibodies on SARS-CoV-2 infection outcomes in exposed household members Journal of infectious diseases 4 April 2025
This study suggests that prior SARS-CoV-2 antibodies provide some protection against Omicron BA.1/BA.2 infection, while effects on symptom burden or CT-value could not be demonstrated. The results highlight the relatively limited, but not negligible role of cross-protective antibodies, especially when facing immune escape variants of SARS-CoV-2.
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