Healthcare today
Healthcare across the world faces existential challenges: escalating demands against constrained resources, increasing co-morbidities and widening inequalities in health.
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Tomorrow's worldInfection and pandemics new
Modelled pandemic costs rise far more from under-control than from over-control
In transmission models fitted to first-year COVID-19 cases in 110 countries, cost-optimal average transmission reduction ranged from 31.2% to 57.3%, and a shortfall of five percentage points was associated with excess costs above 400%, against 10-80% for the same margin above the optimum.
Preprint · not peer-reviewed -
Healthcare todayDementia new
Ultrafine particle exposure is linked to higher dementia mortality in Canadian cities
In 2.1 million adults in Montreal and Toronto followed from 2001 to 2019, each 10,000 particle/cm3 increase in outdoor ultrafine particle concentration was associated with a 22% higher rate of dementia mortality, rising to 49% for vascular dementia.
Peer-reviewed -
Healthcare todayObesity, diabetes and GLP-1 new
Oral safiglipron was non-inferior to dapagliflozin on HbA1c, and superior at 90 mg
In a double-blind phase 3 trial in adults with type 2 diabetes, the once-daily oral small-molecule GLP-1 receptor agonist safiglipron was non-inferior to dapagliflozin for HbA1c reduction at all doses tested and superior at 90 mg, with similar modest weight loss.
Peer-reviewed -
Behavioural scienceAdherence and persistence confirms
Older GLP-1 starters were younger and healthier than those starting other diabetes drugs
Among 58,754 adults aged 65 and over with type 2 diabetes in one regional health system, GLP-1 receptor agonist initiators were on average 75.2 years old against 77.7 for SGLT2 inhibitors and 79.5 for DPP-4 inhibitors, with mean BMI 33.8 against 29.7 and 28.6 kg/m2.
Preprint · not peer-reviewed -
Healthcare todayCancer refines
Total Gleason pattern 4 length outperforms risk groups for surveillance eligibility
In 2499 men with Grade Group 2-4 prostate cancer treated by radical prostatectomy, those with under 2 mm of total Gleason pattern 4, whatever their grade group, had adverse pathology in 5.2% and 5-year biochemical recurrence in 20%, matching favourable intermediate-risk disease.
Peer-reviewed -
Healthcare todayObesity, diabetes and GLP-1 new
One in seven Danish anorexia patients follows a worsening severity course
In a Danish register cohort of 9,534 people with anorexia nervosa, 14% followed a high-increasing severity trajectory, which was associated with a higher anorexia polygenic score and with more psychiatric and somatic diagnoses in the five years after diagnosis.
Preprint · not peer-reviewed -
Tomorrow's worldMedicine at a distance new
Virtual ward patients aged 70+ reported fewer depressive symptoms than inpatients
In a single-trust audit of 100 patients aged 70 and over, 72% of hospital inpatients scored 5 or more on the GDS-15 compared with 30% of those managed on a virtual ward, an unadjusted odds ratio of 6.00 (95% CI 2.53-14.24).
Peer-reviewed -
Healthcare todayMental health new
Mental illness and hip fracture interact to raise 30-day infection risk in older Danes
In a Danish nationwide matched cohort of 100,335 hip fracture patients aged 65 and over and 498,943 comparators, mental health conditions and hip fracture interacted synergistically on 30-day infection risk, with the strongest effect in those with psychoactive substance use disorders.
Peer-reviewed -
Healthcare todayCancer new
PSMA-guided radiotherapy missed its primary endpoint but favoured biochemical control
In a phase 2 randomised trial of 253 men, radiotherapy intensified to all PSMA-PET-detected lesions did not meet its primary endpoint of five-year failure-free survival (66% vs 62%), though freedom from biochemical progression was higher (72% vs 65%).
Peer-reviewed -
Healthcare todayHeart and stroke refines
ORBI score marks larger infarcts in STEMI but predicts 10-year death worse than age
Among 1,574 Danish STEMI patients treated by primary PCI, those scoring high on the ORBI cardiogenic-shock risk score had more inflammation, larger infarcts and 41% versus 20% ten-year mortality, though the score discriminated long-term death less well than age alone.
Peer-reviewed -
Healthcare todayHeart and stroke confirms
US deaths listing both type 2 diabetes and cardiac arrest rose faster after 2014
A CDC WONDER analysis of 258,675 US deaths from 1999 to 2020 mentioning both type 2 diabetes and cardiac arrest found age-adjusted rates rising 2.72% a year to 2014 and 9.55% a year thereafter, highest among Hispanic and American Indian/Alaska Native adults.
Peer-reviewed -
Healthcare todayHeart and stroke new
Japanese romosozumab starters had less recent heart attack or stroke than other users
Among 311,585 Japanese patients starting romosozumab between 2019 and 2023, 11.7% of men and 7.9% of women had a myocardial infarction or stroke in the prior 360 days, below the 8.9-17.6% among users of other osteoporosis drugs, and those with such a history discontinued more often.
Peer-reviewed
