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What’s new in medical literature

What's new in the medical literature?

Updated 23 May 2025

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UpToDate

10-year outcomes of sleeve gastrectomy versus Roux-en-Y gastric bypass
Laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the two most common bariatric procedures; however, long-term comparative data are limited. In a randomized trial comparing the procedures, the mean percentage total weight loss was similar at >25 percent for both SG and RYGB after 10 years of follow-up [4]. However, reoperation for either insufficient weight loss or severe acid reflux was more common after SG (30 versus 6 percent). Given that both procedures produce durable weight loss, the choice may depend on patient preferences, individual risk assessment, and local expertise (See "Outcomes of bariatric surgery", section on 'RYGB and SG'.)

BCG booster does not reduce risk of Mycobacterium tuberculosis infection
In areas with high prevalence of tuberculosis (TB), primary immunization of infants with Bacille Calmette-Guérin (BCG) vaccine is an important prevention tool; a small trial previously suggested that booster immunization might provide additional protection. In a larger follow up study, 1836 adolescents in South Africa with negative interferon-gamma release assay (IGRA) results were randomly assigned to receive BCG booster or placebo and followed with serial IGRA for a median of 30 months [33]. In contrast to the earlier study, BCG booster immunization did not affect the incidence of IGRA conversion (a presumed surrogate for Mycobacterium tuberculosis infection) compared with placebo. Further study is needed for identification of the most effective antigen(s) for TB vaccination. (See "Prevention of tuberculosis: BCG immunization and nutritional supplementation", section on 'Booster immunization'.)

Compression therapy for mixed arterial and venous leg ulcers
The optimal management of mixed arterial and venous leg ulcers (MAVLU) is uncertain. Compression therapy, which is the mainstay of management of venous leg ulcers, can aggravate ischemia and is generally contraindicated for patients with severe peripheral artery disease (PAD). However, modified compression therapy (MCT) may successfully treat MAVLU and moderate PAD. In a meta-analysis, among patients with an ankle-brachial index of 0.5 to 0.85, the pooled rate of ulcer healing using initial MCT was 75 percent [15]. However, 25 percent required rescue revascularization for complete ulcer healing. While these results support initial MCT for MAVLU and moderate PAD, these patients should be referred to a vascular specialist for further evaluation and possible intervention. (See "Compression therapy for the treatment of chronic venous insufficiency", section on 'Contraindications'.)

Exercise to prevent sarcopenia in older adults
Strength training has been studied as a method for preventing sarcopenia in older adults. In the randomized multicenter European DO-HEALTH trial, 1495 community-dwelling adults over 70 were assigned to an exercise intervention that consisted of five simple exercises using only bodyweight or light resistance with no planned increases in load or normal activities three times weekly [13,14]. This intervention had no impact on sarcopenia over three years. These data confirm prior studies that document the ineffectiveness of strength programs that do not emphasize robust exercises with progressive increases in load. (See "Practical guidelines for implementing a strength training program for adults", section on 'General principles'.)

Fluid restriction in patients with stable heart failure
In patients with heart failure (HF), the efficacy of fluid restriction remains uncertain. In a recent trial in over 500 patients with New York Heart Association class II or III HF who were randomly assigned to liberal fluid intake (ie, no maximum per day) or restricted fluid intake (ie, <1500 mL per day), rates of death, all-cause hospitalization, and intravenous loop diuretic use at three months were similar between the groups [18]. Notably, patients in both groups reported daily fluid intake of less than two liters (1764 and 1480 mL in the liberal and fluid restriction groups, respectively), which may have biased the trial toward a null result. Patients with stable HF do not require a specific fluid restriction, but in patients whose fluid intake is associated with HF exacerbation or significant hyponatremia, it is reasonable to provide an individualized and achievable fluid restriction. (See "Heart failure self-management", section on 'Fluid restriction'.)

Impact of herpes zoster vaccination on dementia risk
A number of observational studies have suggested that herpes zoster vaccination may reduce the risk of dementia. Further evidence of a protective effective from the vaccine comes from two large database studies in Wales and Australia, which estimated that eligibility for the herpes zoster vaccine program reduced the absolute incidence of a dementia diagnosis by 1 to 2 percent over approximately seven years of follow-up [9,10]. Further data are needed to confirm the benefit in terms of dementia risk, but we continue to encourage age-appropriate herpes zoster vaccination to prevent herpes zoster and postherpetic neuralgia. (See "Prevention of dementia", section on 'Herpes zoster vaccination'.)

Induction versus standard care to prevent shoulder dystocia when large for gestational age is suspected
Large for gestational age (LGA) fetuses are at increased risk of shoulder dystocia, but convincing outcome data regarding the benefits and risks of early induction of labor have not been available. In the largest randomized trial of fetuses suspected to be LGA (estimated fetal weight >90th customized percentile), induction between 38 weeks 0 days and 38 weeks 4 days resulted in no statistically significant reductions in shoulder dystocia or its neonatal consequences compared with standard care (induction at ≥39 weeks) [12]. Of note, patients with diabetes were excluded, and only approximately 40 percent of the fetuses in each group were actually LGA at birth. In our practice, we offer induction to patients at 39 weeks of gestation with estimated fetal weight between 4000 and 5000 g and without diabetes. (See "Shoulder dystocia: Risk factors and planning birth of high-risk pregnancies", section on 'Patients without diabetes'.)

Nonsteroidal antiinflammatory drugs for pain control in patients with acute renal colic
Kidney stones often present with acute and intense abdominal and/or flank pain (ie, renal colic); we suggest nonsteroidal antiinflammatory drugs (NSAIDs) as the initial choice for pain control in most patients presenting with acute renal colic. A recent Cochrane systematic review of 29 randomized trials (nearly 3600 patients) found that NSAIDs are more effective than placebo in reducing pain (defined as the change in VAS-10 cm pain scores from baseline to 30 minutes after intervention; mean difference -3.84 cm, 95% CI -6.41 to -1.27) [7]. Patients receiving NSAIDs were also less likely to require rescue pain medication than those receiving placebo. These findings provide additional support for the use of NSAIDs as initial pain control in patients with acute renal colic. (See "Kidney stones in adults: Diagnosis and acute management of suspected nephrolithiasis", section on 'Pain control'.)

Reversal strategy for intracerebral hemorrhage associated with direct factor Xa inhibitors
For direct factor Xa inhibitor-associated intracerebral hemorrhage, we suggest either andexanet alfa or 4-factor prothrombin complex concentrate (PCC) based on the severity of hemorrhage, local protocols, and availability (Grade 2C). Andexanet may restore hemostasis more effectively than PCC but is associated with higher thrombotic risk. The optimal reversal strategy for direct factor Xa inhibitors (apixaban, edoxaban, rivaroxaban) in acute intracerebral hemorrhage (ICH) is uncertain. In the ANNEXA-I trial, which randomly assigned 530 patients with factor Xa inhibitor-associated ICH to andexanet alfa or standard care (typically including a prothrombin complex concentrate [PCC]), patients assigned to andexanet had higher rates of hemostasis than those assigned to standard therapy (67 versus 53 percent) [22]. However, thrombotic events, including ischemic stroke and myocardial infarction, were more common with andexanet (10.3 versus 5.6 percent). Mortality and functional outcomes at 30 days were similar. Based on these results, we individualize selection of andexanet alfa or PCC for direct factor Xa inhibitor reversal in acute ICH and other life-threatening bleeding; previously, we favored andexanet in most cases. Andexanet may restore hemostasis more effectively than PCC but is associated with higher thrombotic risk. (See "Reversal of anticoagulation in intracranial hemorrhage", section on 'Reversal agent options'.)

Securing central venous catheter dressings
A central venous catheter (CVC) must be secured to the skin to stabilize it, but the optimal dressing is unclear. In a randomized trial of patients undergoing jugular CVC insertion, application of medical liquid adhesive (MLA) under the standard CVC dressing border resulted in fewer dressing failures due to lifting edges at seven days compared with a standard dressing alone (28 versus 50 percent) [23]. Skin complications were similar between the groups. While MLA improved catheter securement and dressing integrity, a larger trial is needed to evaluate clinically important outcomes such as infection, catheter loss, and other complications. (See "Routine care and maintenance of intravenous devices", section on 'Device securement'.)

Timing of primary repair of open-globe injury
Definitive management of an open-globe injury is primary closure by an ophthalmologist, but practice variation exists regarding the timing of surgery. Infection (ie, endophthalmitis) is associated with poor visual outcomes. A meta-analysis that included over 6400 eyes found that primary repair within 24 hours after injury, compared with beyond 24 hours, was associated with a lower rate of endophthalmitis (11 versus 28 percent) [36]. These findings support our advice that closure within 24 hours of injury is ideal. (See "Open globe injuries: Emergency evaluation and initial management", section on 'Definitive management'.)
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Cochrane Library

Anti‐IL‐12/23p40 antibodies for induction of remission in Crohn's disease Cochrane Library 13 May 2025
Ustekinumab reduces the risk of people with CD failing to enter clinical remission at eight weeks. It probably does not lead to more serious adverse events when compared to placebo. There were inadequate data to conclude the more effective induction dose of ustekinumab in children. No studies evaluated adverse events at eight weeks for this comparison. There may be little to no difference between ustekinumab and other biologics, such as adalimumab or guselkumab, in inducing clinical remission at week 8, but the evidence is very uncertain, and separate data on adverse events at eight weeks were not available.

Atypical antipsychotics for autism spectrum disorder: a network meta‐analysis Cochrane Library 21 May 2025
Risperidone and aripiprazole may reduce symptoms of irritability compared to placebo in children with ASD in the short term, but lurasidone probably has little to no effect on irritability compared to placebo. Other benefits and potential harms observed ranged from moderate‐ to very low‐certainty evidence. The available data did not allow comprehensive subgroup analyses. New randomised controlled trials with larger sample sizes are needed to balance the efficacy and safety of interventions with enough certainty, which are currently scarce (or even absent in the case of the adult population). Authors should report population and intervention characteristics transparently, providing disaggregated or individual patient data when possible. Furthermore, consistent measurement methods for each outcome should be reported to avoid problems during the data synthesis process.

Clinical pathways for secondary care and the effects on professional practice, patient outcomes, length of stay and hospital costs Cochrane Library 14 May 2025
Stand‐alone CPWs are likely to reduce inhospital complications and length of hospital stay and may slightly increase adherence to recommended practice. There was little conclusive evidence for multifaceted CPWs due to mixed results from a limited number of included studies. It is uncertain whether stand‐alone CPWs or CPWs, as part of a multifaceted approach, reduce inhospital mortality, mortality (up to 6 months), hospital readmission (up to 6 months) or costs and charges.

Early discharge with home support of gavage feeding for stable preterm infants who have not established full oral feeds Cochrane Library 13 May 2025
The currently available evidence, from one small quasi‐RCT conducted in the 1990s, indicates early discharge with home support of gavage feeding compared with later discharge on full sucking feeds may result in little to no difference in weight gain up to discharge from home support/hospital, breastfeeding at discharge and at three months, and rehospitalisation up to 12 months. Early discharge with support versus later discharge may reduce the risk of respiratory infections but result in little to no difference in intravenous antibiotic use up to discharge from home support/hospital. The evidence for all outcomes is very uncertain. There is a need for high‐quality RCTs to determine the benefits and harms of early discharge with home support for stable preterm infants in diverse settings and populations. The two ongoing studies (one completed but unpublished, the other with an unclear status) may contribute to addressing some of these gaps.

Electromechanical‐assisted training for walking after stroke Cochrane Library 14 May 2025
Moderate‐certainty evidence shows that people who receive electromechanical‐assisted gait training in combination with physiotherapy after stroke are probably more likely to achieve independent walking than people who receive gait training without these devices.

Interventions for idiopathic steroid‐resistant nephrotic syndrome in children Cochrane Library 8 May 2025
Calcineurin inhibitors may increase the likelihood of complete or partial remission compared with placebo/no treatment or cyclophosphamide. For other regimens, it remains unclear whether the interventions alter outcomes because the certainty of the evidence is low. Further adequately powered, well‐designed RCTs are needed to evaluate other regimens for children with idiopathic steroid‐resistant nephrotic syndrome (SRNS). Since SRNS represents a spectrum of diseases, future studies should enrol children from better‐defined groups of people with SRNS.

Prophylactic abdominal drainage for pancreatic surgery Cochrane Library 16 May 2025
The evidence is very uncertain about the effect of drain use compared with no drain use on 90‐day mortality, intra‐abdominal infection rate, and wound infection rate in people undergoing either pancreaticoduodenectomy or distal pancreatectomy. The evidence is also very uncertain whether an active drain is superior, equivalent, or inferior to a passive drain following pancreaticoduodenectomy. Moderate‐certainty evidence suggests that early drain removal is probably superior to late drain removal in terms of intra‐abdominal infection rate following pancreaticoduodenectomy for people with low risk of postoperative pancreatic fistula.

Sustained‐release naltrexone for opioid dependence Cochrane Library 9 May 2025
Sustained‐release naltrexone may slightly increase illicit opioid use and serious adverse events compared to opioid agonists, with uncertain effects on retention and acceptability. It may reduce illicit opioid use compared to oral naltrexone but has uncertain effects on other outcomes. Compared to placebo, it may have little to no impact on key outcomes. Compared to treatment as usual, it reduces illicit opioid use and may reduce serious adverse events but has little effect on retention and slightly reduces acceptability. Significant gaps remain in the evidence on sustained‐release naltrexone for opioid dependence. Future research should include comparisons with psychosocial treatments, larger and higher‐quality studies, and analyses of differences between formulations and comparator treatments. Improved study designs are needed to reduce bias, and more inclusive research should address under‐represented populations and synthetic opioid users. The lack of long‐term outcome data limits understanding of sustained effects, highlighting the need for extended follow‐up and exploration of diverse treatment settings and populations.

Vaccines for preventing infections in adults with haematological malignancies Cochrane Library 21 May 2025
The evidence on vaccines for preventing infections in adults with haematological malignancies is limited and uncertain. Herpes zoster vaccines may reduce infection risk for up to 21 months, but the certainty of the evidence is low. While there is a considerable increase in short‐term adverse events (high‐certainty evidence), no increase in serious adverse events was observed at up to 12 months (moderate‐certainty evidence). Data on long‐term impacts on other outcomes are lacking. For COVID‐19 and influenza vaccines, the evidence is very uncertain. We found no studies that could be included in the review of vaccines for our other infectious diseases of interest: diphtheria, Haemophilus influenzae type b (Hib), hepatitis B, Neisseria meningitidis , pertussis, polio, Streptococcus pneumoniae, or tetanus. Our review underscores the need for high‐quality RCTs and controlled NRSIs with better reporting, larger samples, longer follow‐ups, and a focus on patient‐relevant outcomes, such as quality of life and long‐term safety. A robust and continuously updated evidence base is essential to guide clinical and public health decisions.
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MJA

Hyperkalaemic cardiac arrest due to cream of tartar ingestion MJA 13 May 2025
Lessons from practice

  • Potassium bitartrate (cream of tartar) is a common household item that presents an under-recognised danger and can cause hyperkalaemic cardiac arrest.
  • Early recognition and rapid treatment can prevent mortality.
  • Understanding of the anticipated course of potassium bitartrate ingestions will benefit clinicians to initiate urgent patient transfer.
  • Warning labels should be incorporated in packaging to avoid recurrence.

Smartphone-activated volunteer responders and survival to discharge after out-of-hospital cardiac arrests in Victoria, 2018–23: an observational cohort study MJA 19 May 2025
The known: Bystander cardiopulmonary resuscitation and defibrillation improve survival for people who experience out-of-hospital cardiac arrest.
The new: Survival to hospital discharge was 37% more likely (risk-adjusted) after out-of-hospital cardiac arrest if smartphone-activated volunteer responders arrived before emergency medical services, but it was not influenced if they arrived after the paramedics.
The implications: Smartphone-activated volunteer responder programs could increase the likelihood of survival after out-of-hospital cardiac arrest if responders arrive before emergency medical services. Volunteer response times should be improved, and safeguards developed for limiting the exposure of volunteer responders to distressing cases, particularly for responders arriving after paramedics.

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MJA insight

Culturally responsive asthma management is essential for Indigenous women during pregnancy MJA insight 12 May 2025
Culturally responsive management of asthma during pregnancy in Aboriginal and Torres Strait Islander women needs some serious attention if we are to improve birth outcomes.

Gestational diabetes soars by 70% in Australia: what’s driving the surge? MJA insight 19 May 2025
Gestational diabetes mellitus (GDM) prevalence has surged by almost 70% in five years, putting thousands of women and their babies at risk of future health complications. Of particular concern is the Northern Territory, which has almost tripled its incidence of GDM, while Victoria has doubled its incidence.

People’s mental health goes downhill after repeated climate disasters – it’s an issue of social equity MJA insight 19 May 2025
Across Australia, communities are grappling with climate disasters that are striking more frequently and with greater intensity. Bushfires, floods and cyclones are no longer one-off events. And this pattern is predicted to worsen due to climate change. As it becomes more common to face climate disasters again and again, what does this mean for the mental health and wellbeing of people affected?

Premature and early menopause: the overlooked risk in endometriosis MJA insight 19 May 2025
People with endometriosis are seven times more likely to undergo surgical menopause and face an increased risk of premature menopause before the age of 40, either naturally or through surgery, than those without endometriosis.

Reassuring new evidence about the safety of smoking cessation pharmacotherapies during pregnancy MJA insight 12 May 2025
A multinational cohort study led by Australian researchers finds no clear evidence that prenatal exposure to smoking cessation pharmacotherapies causes congenital malformations in babies

Supporting adolescent wellbeing in the digital age MJA insight 19 May 2025
Adolescents must be involved in the development of digital health care initiatives if they are to be engaging and effective.

Understanding the genetic basis of eating disorders: insights from the EDGI2 study MJA insight 12 May 2025
The Eating Disorders Genetic Initiative (EDGI2) aims to identify the genes that predispose individuals to eating disorders to revolutionise future research into causes, treatment and prevention of the illness.

Virtual hospitals will play an important role in Australia’s future, but private providers face roadblocks to innovation MJA insight 19 May 2025
Private virtual hospitals offer an unprecedented opportunity to improve timely access to hospital care, especially for people in rural and remote areas, but critical barriers need to be addressed.

What works (and what doesn’t) for lower back pain MJA insight 12 May 2025
Lower back pain is a common presentation in general practice, and with many treatments available, knowing which ones are effective — and which are not — can guide better care.

Why children in care deserve priority health care access MJA insight 12 May 2025
Children in care need a streamlined, consistent health system regardless of where they live or how frequently their circumstances change.

Why doesn’t Australia make more medicines? Wouldn’t that fix drug shortages? MJA insight 19 May 2025
About 400 medicines are in short supply in Australia. Of these, about 30 are categorised as critical. These are ones with a life-threatening or serious impact on patients, and with no readily available substitutes. Since 2024, there has been a nationwide shortage of sterile fluid. This continues to affect health care across Australia. However, medicine shortages in Australia are not new. We know from past experience that six classes of medications are the most likely to go short: antibiotics, anaesthesia and pain relief treatments, heart and blood pressure medications, hormonal medications, cancer treatments and epilepsy medications. So, could we prevent medication shortages if Australia made more medicines?
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BMJ

Assessment and investigation of thunderclap headache BMJ 15 May 2025
What you need to know

  • Thunderclap headache is associated with high risk aetiologies, such as subarachnoid haemorrhage and intracranial haemorrhage.
  • Delayed diagnosis is associated with worse clinical outcomes.
  • The Ottawa subarachnoid haemorrhage rule has a high sensitivity and low specificity. It can help identify patients who are at low risk for non-traumatic subarachnoid haemorrhage and reduce unnecessary investigations.
  • Early imaging (non-contrast CT (computed tomography) within 6 hours) and, if necessary, lumbar puncture, are first line diagnostic investigations.
  • CT angiography for subarachnoid haemorrhage can identify vascular causes of thunderclap headache and could be an alternative to lumbar puncture in select cases.

Can AI teach medicine? BMJ 14 May 2025
Artificial intelligence is making significant inroads into healthcare, diagnostics, workflows, and even medical education. But can AI truly take on the role of a teacher in medical training?

Diagnosis and management of gonorrhoea BMJ 19 May 2025
What you need to know

  • Increasing incidence of gonorrhoea is likely to lead to more complicated and systemic presentations such as pelvic inflammatory disease, septic arthritis, and neonatal infection
  • Increasing antimicrobial resistance is limiting treatment options for gonorrhoea, and management of suspected and confirmed cases must seek to minimise the development of further resistance. Gaining specimens for culture and sensitivity to guide treatment and monitor resistance patterns prior to treatment is crucial
  • Gonorrhoea disproportionately affects marginalised groups, such as men who have sex with men and some ethnic minorities, and control will not be achieved without dismantling systemic barriers to good sexual health

Enteral tube feeding in people with advanced dementia BMJ 15 May 2025
What you need to know

  • Difficulty eating is a common complication of advanced dementia. Choosing Wisely lists and professional society guidelines recommend against insertion of enteral feeding tubes, and instead recommend careful assisted oral feeding
  • Early discussions about prognosis, shared decision making, and advance care planning that anticipates feeding difficulties may improve care in advanced dementia
  • Rates of enteral tube feeding in advanced dementia have declined in the UK, Europe, and Canada
  • A palliative approach to feeding problems in advanced dementia can promote goal concordant care

Obesity: can we cure our dependence on BMI? BMJ 19 May 2025
Obesity remains defined by the flawed metric at the heart of its diagnosis—BMI.

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JAMA

A multidimensional diagnostic approach for Chronic Obstructive Pulmonary Disease JAMA 18 May 2025
This new COPD diagnostic schema, which includes chest imaging, respiratory symptoms, and spirometry, identified additional individuals at risk for poor respiratory outcomes.

Glucagon-Like Peptide 1 receptor agonists and mental health: A systematic review and meta-analysis JAMA 14 May 2025
Treatment with GLP1-RAs is safe from a psychiatric perspective and may be associated with improved mental well-being, which should be considered when deciding among treatment options for obesity and diabetes given the association between these conditions and poorer mental health and quality of life.

Glucose-lowering medications, glycemia, and cognitive outcomes: The GRADE randomized clinical trial JAMA 19 May 2025
The results of this randomized clinical trial suggest that choice of second-line glucose-lowering medication class added to metformin is not associated with change in cognitive performance in persons with early T2D. Worse glycemic control is associated with modestly worse cognitive performance.

Health outcomes of discontinuing antipsychotics after hospitalization in older adults JAMA 14 May 2025
Based on 2 nationwide US cohorts including older adults without psychiatric disorders, antipsychotic medications (APMs) discontinuation was associated with reduced risks of all-cause rehospitalization and mortality, suggesting the importance of minimizing the duration of APM use after acute hospitalization.

Loss of PTSD diagnosis in response to evidence-based treatments: A systematic review and meta-analysis JAMA 21 May 2025
This systematic review and meta-analysis contributes to the substantial literature on psychotherapeutic treatments for PTSD by meta-analyzing the probabilities of diagnosis loss for each psychotherapy. Diagnosis loss data are a relatively straightforward way to discuss potential benefits when initiating a therapy or when discussing potential barriers to progress in treatment.

Personalized visual perceptual learning digital therapy for visual field defects following stroke: A randomized clinical trial JAMA 19 May 2025
In this randomized clinical trial of a digital therapeutic for chronic poststroke visual field defects (VFDs), the visual perceptual learning–based training demonstrated significant improvements in the whole field and defective hemifield.

Role of preoperative antibiotic treatment while awaiting Appendectomy: The PERFECT-antibiotics randomized clinical trial JAMA 14 May 2025
In this multicenter noninferiority randomized clinical trial, preoperatively started antibiotic treatment did not decrease the risk of appendiceal perforation when appendectomy was performed within 24 hours in adult patients with presumed uncomplicated acute appendicitis.
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NEJM

As-needed Albuterol–Budesonide in mild Asthma NEJM 19 May 2025
As-needed use of albuterol–budesonide resulted in a lower risk of a severe asthma exacerbation than as-needed use of albuterol alone among participants with disease that was uncontrolled despite treatment for mild asthma.

First-line treatment of Pulmonary Sarcoidosis with Prednisone or Methotrexate NEJM 18 May 2025
In patients with pulmonary sarcoidosis, initial treatment with methotrexate was noninferior to that with prednisone with regard to the change from baseline to week 24 in the percentage of the predicted forced vital capacity (FVC). Differences in the side-effect profile between methotrexate and prednisone may inform shared decision making by providers and patients about the appropriate treatment approach.

Intravenous Tenecteplase before thrombectomy in stroke NEJM 21 May 2025
Among patients with acute ischemic stroke due to large-vessel occlusion who had presented within 4.5 hours after onset, the percentage of patients with functional independence at 90 days was higher with intravenous tenecteplase plus endovascular thrombectomy than with endovascular thrombectomy alone.

Tirzepatide as compared with Semaglutide for the treatment of obesity NEJM 11 May 2025
Among participants with obesity but without diabetes, treatment with tirzepatide was superior to treatment with semaglutide with respect to reduction in body weight and waist circumference at week 72.
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Other journals

A meta-analysis of the diagnostic test accuracy of artificial intelligence predicting emergency department dispositions BMC medical informatics and decision making 15 May 2025
The meta-analysis indicates promising performance of AI in predicting ED disposition, with certain potential for improvement, especially in sensitivity. Future research could explore advanced AI techniques such as ensemble learning and cross-validation with hyper-parameter tuning to enhance predictive model efficacy.

Air pollution and atherosclerosis Atherosclerosis 16 May 2025
Highlights

  • The pro-atherosclerotic effects of air pollution contribute to its high levels of cardiovascular morbidity and mortality
  • Many epidemiological studies find positive associations between air pollutants and atherosclerosis
  • Mechanistic studies find that air pollutants promote the development of atherosclerotic plaques through multiple pathways
  • There is an urgent need to reduce air pollutant emissions to limit the development and consequences of atherosclerosis

Application of artificial intelligence medical imaging aided diagnosis system in the diagnosis of pulmonary nodules BMC medical informatics and decision making 14 May 2025
The results showed that the AI software detected a total of 881 true nodules with a sensitivity of 99.10% (881/889). The radiologists detected 385 true nodules with a sensitivity of 43.31% (385/889). The sensitivity of AI software in detecting non-calcified nodules was significantly higher than that of radiologists (99.01% vs 43.30%, P < 0.001), and the difference was statistically significant.

Automated chest compression devices Canadian journal of health technologies 22 May 2025
What Did We Find?

  • We identified 4 systematic reviews (SRs) that examined the clinical effectiveness or safety of automated chest compressions via AutoPulse or Lund University Cardiopulmonary Assist System (LUCAS) devices compared to manual chest compressions, and 2 guidelines with recommendations for the use of automated chest compression devices overall. We did not find information for other devices licensed for sale in Canada. We did not find economic evaluations on the cost-effectiveness of automated chest compression devices.
  • Clinical evidence showed mixed results on survival, neurologic outcomes, and return to spontaneous circulation between automated chest compressions and manual chest compressions, and a potential increase in harms with the use of these devices. However, these findings are based on heterogeneous evidence of variable quality and should be interpreted with caution.
  • Evidence-based guidelines do not recommend the routine use of automated chest compression devices. They indicate that these devices could be applied under specific circumstances, such as when high-quality compressions are impractical or a danger to health care workers, provided professionals are trained and have experience with the device.
  • Evidence was largely based on studies conducted outside of Canada, making the generalizability of the evidence unclear. One primary study found in 3 of the 4 SRs had a population from Canada, and no other clinical evidence was from Canada. No evidence-based guidelines were found from Canadian organizations.
  • Most of the evidence did not include details about study participant demographics or dimensions of diversity or information specifically for rural, remote, territorial hospital, nurse-led hospital, small community, or tertiary care settings. The applicability of the evidence is unknown, including the potential benefits or harms in people with different sexes or genders; different ethnic, religious, educational, socioeconomic, or cultural backgrounds; or with limited access to health care services or in resource-limited settings.

Comprehensive analysis of knee cysts: diagnosis and treatment Knee surgery & related research 14 May 2025
This review underscores the importance of tailored, evidence-based approaches in managing knee cysts to optimize patient outcomes.

Effect of nurse’s verbal communication on the level of consciousness, pain, and agitation in anesthetized patients admitted to the intensive care unit: a double-blind clinical trial BMC anesthesiology 10 May 2025
The findings of this study indicate that verbal communication had a positive impact on the level of consciousness, pain, and agitation of anesthetized patients in ICUs. Implementing verbal communication as an intervention by nurses can be an effective approach in medical centers.

Evaluating the therapeutic efficacy and safety of alginate-based dressings in burn wound and donor site wound management associated with burn surgery: a systematic review and meta-analysis of contemporary randomized controlled trials BMC surgery 16 May 2025
Our findings indicate that alginate dressings not only significantly reduce healing time but also offer clinically relevant benefits, including reduced pain and fewer dressing changes, making them a valuable option in burn wound management. However, their effect on dressing change frequency and adverse events remains comparable to control treatments. Despite the methodological limitations such as high heterogeneity and potential biases, alginate dressings maintain advantages in clinical settings. Standardization of evaluation criteria and long-term studies are necessary to enhance the understanding and application of alginate dressings in diverse burn wound and donor site wound care settings.

Patterns of intimate partner violence in Victoria, Australia: analysis using the National Ambulance Surveillance System Health and place 9 May 2025
Highlights

  • Ambulance data can inform an intimate partner violence surveillance system.
  • Paramedics are front-line responders to victim survivors after acute violent events.
  • Victim survivors from areas of greater socio-economic disadvantage were more likely to have an IPV-related attendance.
  • Victim survivors from more regional or remote locations were more likely to have an IPV-related ambulance attendance.

Physical disability and psychological distress before and after a diagnosis of cancer: evidence on multiple cancer types from a large Australian cohort study, compared to people without a cancer diagnosis BMC medicine 15 May 2025
On average, cancer survivors experienced greater declines in physical wellbeing than people without cancer and minimal differences in psychological distress. Those not receiving recent cancer treatment and those with many common cancer types had physical and psychological outcomes comparable to people without cancer. Additional targeted support may particularly benefit those receiving treatment, with specific cancer types, and advanced disease.

Prevalence of self-medication with vitamin or mineral supplements in the prevention and treatment of COVID-19: a systematic review and meta-analysis BMC nutrition 20 May 2025
The reported prevalence of self-medication with vitamins and minerals to prevent and treat COVID-19, especially in Asia, is concerning and needs more public health action. In addition, people should be educated about the possibility of poisoning with vitamins and minerals because awareness of the risks of supplements can reduce self-medication practices at present and even in future pandemics.

Real-world data on the use of the Shingrix vaccine among patients with inflammatory arthritis and risk of cardiovascular events following herpes zoster Arthritis research & therapy 17 May 2025
This study showed that the effectiveness of Shingrix in patients with inflammatory arthritis on immunomodulatory treatment was 50%, and the risk of venous thromboembolic events was increased in the 60–90 days after herpes zoster, supporting the recommendation that adults with inflammatory arthritis should receive vaccination against herpes zoster to reduce the risk of such events.

Reducing the length of hospital stay for patients undergoing primary total knee arthroplasty by application of enhanced recovery after surgery (ERAS) pathway: a multicenter, prospective, randomized controlled trial European journal of medical research 14 May 2025
The application of an Enhanced Recovery After Surgery (ERAS)  pathway for primary Total knee arthroplasty (TKA) significantly reduces length of hospital stay (LOS), alleviates postoperative pain, and lowers the incidence of adverse events compared to perioperative management without ERAS pathway implementation.

The association between HPV vaccination and new-onset cardiovascular and cerebrovascular diseases: based on a retrospective study Journal of health, population and nutrition 19 May 2025
HPV vaccination is linked to a lower risk of new-onset cardiovascular and cerebrovascular diseases in adults, suggesting broader health benefits beyond cancer prevention. These results advocate for incorporating cardiovascular health into public health strategies promoting HPV vaccination. Further research is necessary to understand the mechanisms and validate these protective effects across diverse populations and extended follow-up periods.

Type 2 diabetes mellitus as a predictor of severe outcomes in COVID-19 — a systematic review and meta-analyses BMC infectious diseases 19 May 2025
T2DM is associated with significantly worse outcomes in COVID-19 patients, including higher mortality, higher severity and a greater likelihood of needing mechanical ventilation. These findings emphasize the need for targeted interventions and management strategies for individuals with T2DM during the ongoing pandemic. Future research should focus on understanding the underlying mechanisms and exploring strategies to mitigate these risks.

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