Generative AI’s diagnostic capabilities comparable to non-specialist doctors, claims research

The use of generative AI for diagnostics has attracted attention in the medical field and many research papers have been published on this topic. However, because the evaluation criteria were different for each study, a comprehensive analysis was needed to determine the extent AI could be used in actual medical settings and what advantages it featured in comparison to doctors.

A research group led by Dr. Hirotaka Takita and Associate Professor Daiju Ueda at Osaka Metropolitan University’s Graduate School of Medicine conducted a meta-analysis of generative AI’s diagnostic capabilities using 83 research papers published between June 2018 and June 2024 that covered a wide range of medical specialties.

Of the large language models (LLMs) that were analyzed, ChatGPT was the most commonly studied.

The comparative evaluation revealed that medical specialists had a 15.8% higher diagnostic accuracy than generative AI. The average diagnostic accuracy of generative AI was 52.1%, with the latest models of generative AI sometimes showing accuracy on par with non-specialist doctors.

“This research shows that generative AI’s diagnostic capabilities are comparable to non-specialist doctors. It could be used in medical education to support non-specialist doctors and assist in diagnostics in areas with limited medical resources.” stated Dr. Takita.

“Further research, such as evaluations in more complex clinical scenarios, performance evaluations using actual medical records, improving the transparency of AI decision-making, and verification in diverse patient groups, is needed to verify AI’s capabilities.”

The findings were published in npj Digital Medicine.

Reference:

Hirotaka Takita, Daijiro Kabata, Shannon L. Walston, Hiroyuki Tatekawa, Kenichi Saito, Yasushi Tsujimoto, Yukio Miki, Daiju Ueda. A systematic review and meta-analysis of diagnostic performance comparison between generative AI and physicians. npj Digital Medicine, 2025; 8 (1) DOI: 10.1038/s41746-025-01543-z

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Vitamin C Deficiency Linked to Poor Lung Recovery and Delayed Tuberculosis Clearance, Study Finds

Romania: A recent prospective study published in Frontiers in Medicine highlights the crucial role of vitamin C in influencing the course and treatment outcomes of pulmonary tuberculosis (TB). The findings reveal that vitamin C deficiency slows bacterial clearance during therapy and contributes to more severe lung damage and impaired respiratory function.

Patients with low vitamin C levels had slower recovery, with only 68% achieving bacterial clearance at six months versus 89.8% in those with normal levels. They also showed more lung damage—bronchiectasis, fibrosis, and cavitary lesions—and greater declines in lung function, including a 12% drop in forced vital capacity and a larger decrease in the Tiffeneau index (3.34 vs. 2.13).

Vitamin C is essential for a robust immune response to tuberculosis, and its deficiency can elevate the risk of TB and related complications. Despite its importance, the connection between vitamin C levels and the severity of TB has not been thoroughly explored.

Ramona Cioboata, Department of Pneumology, University of Medicine and Pharmacy of Craiova, Craiova, Romania, and colleagues sought to bridge this gap by investigating the relationship between vitamin C deficiency, disease severity, and imaging findings in TB patients. The study highlighted that low vitamin C levels were linked to worse disease outcomes, underscoring the critical role of this nutrient in both the immune response and overall TB management.

For this purpose, the researchers enrolled 109 patients with confirmed pulmonary tuberculosis, diagnosed through Mycobacterium tuberculosis culture. The participants were divided into two groups based on their serum vitamin C levels: 59 patients (54.13%) with normal levels and 50 patients (45.87%) with low levels.

The study revealed the following findings:

  • At baseline, patients with low vitamin C levels had higher bacillary loads, with 86% showing loads of 2+ or higher, compared to 59.32% in the normal group.
  • After two months, 83.05% of the normal vitamin C group achieved culture conversion, while only 28% of the low vitamin C group reached this milestone.
  • CT scans at baseline showed that the low vitamin C group had a higher frequency of the tree-in-bud pattern (2.66 vs. 2.05).
  • The low vitamin C group also had more cavitary lesions, especially in the superior right and left lobes.
  • After six months, the low vitamin C group had a higher prevalence of bronchiectasis (0.58 vs. 0.16), cavitary lesions (0.32 vs. 0.00), and fibrosis (0.90 vs. 0.36).
  • Pulmonary function tests revealed greater impairment in the low vitamin C group, with a 5.77% decrease in forced expiratory volume, a 12% reduction in forced vital capacity (FVC), and a 3.34-point drop in the Tiffeneau index.
  • Receiver operating characteristic (ROC) analysis showed that FVC and forced expiratory flow were stronger predictors of treatment success in patients with normal vitamin C levels.

The authors concluded that vitamin C deficiency in tuberculosis patients is associated with greater disease severity, delayed bacterial clearance, and persistent lung damage. They suggested vitamin C supplementation could support standard TB therapy and improve outcomes.

However, they acknowledged limitations such as the study’s observational design, small sample size, and potential confounding factors like diet, smoking, and comorbidities. They called for larger, randomized trials to confirm these findings and establish causality.

Reference:

Cioboata, R., Balteanu, M. A., Zlatian, O. M., Vlasceanu, S. G., Driga, M. V., Mitroi, D. M., Catana, O. M., Buciu, C. I., Camen, G., & Mirea, A. A. (2025). Impact of vitamin C deficiency on imaging patterns and ventilatory function in pulmonary tuberculosis. Frontiers in Medicine, 12, 1554723. https://doi.org/10.3389/fmed.2025.1554723

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Study suggests obesity contributes to anxiety and cognitive impairment

With rates of obesity and anxiety both on the rise-especially among younger Americans-new research suggests that the two conditions may be connected through interactions between the gut and the brain. The study, conducted in mice, links diet-induced obesity with anxiety-like symptoms, alterations in brain signaling and differences in gut microbes that may contribute to impaired brain functioning.

“Several studies have pointed to a link between obesity and anxiety, though it is still unclear whether obesity directly causes anxiety or if the association is influenced by societal pressures,” said Desiree Wanders, PhD, associate professor and chair of nutrition at Georgia State University. “Our findings suggest that obesity can lead to anxiety-like behavior, possibly due to changes in both brain function and gut health.”

Wanders will present the findings at NUTRITION 2025, the flagship annual meeting of the American Society for Nutrition held May 31–June 3 in Orlando, Florida.

While it is well established that obesity can lead to conditions like type 2 diabetes and heart disease, the potential impacts on brain health are less clear. To probe the connections between obesity, cognitive function and anxiety, the researchers designed a series of experiments using a mouse model that develops many of the same obesity-related issues seen in humans.

The study included 32 male mice. From 6 to 21 weeks of age-a period equivalent to adolescence into early adulthood in humans-half of the mice were fed a low-fat diet and half were fed a high-fat diet. By the end of this period, mice on a high-fat diet weighed significantly more and had significantly more body fat than those fed a low-fat diet.

In behavioral tests, the researchers found that the obese mice displayed more anxiety-like behaviors, such as freezing (a defensive behavior mice exhibit in response to a perceived threat), compared with lean mice. These mice also showed different signaling patterns in the hypothalamus, a region of the brain involved in regulating metabolism, which could contribute to cognitive impairments.

In addition, the researchers observed distinct differences in the makeup of gut bacteria in obese mice compared with lean mice. These findings align with a growing body of evidence pointing to the role of the gut microbiome in regulating behavior.

While recognizing that research in mice does not always translate directly to humans, Wanders said that the results provide new insights that underscore the importance of targeting multiple systems in understanding and potentially treating obesity-related cognitive impairments.

“These findings could have important implications for both public health and personal decisions,” said Wanders. “The study highlights the potential impact of obesity on mental health, particularly in terms of anxiety. By understanding the connections between diet, brain health and gut microbiota, this research may help guide public health initiatives that focus on obesity prevention and early intervention, particularly in children and adolescents.”

Wanders also noted that the carefully controlled conditions used in the study lend rigor and credibility to the results but added that the real world is much more complex.

“While our findings suggest that diet plays a significant role in both physical and mental health, it is important to remember that diet is just one piece of the puzzle,” said Wanders. “Environmental factors, genetics, lifestyle choices and socioeconomic status also contribute to the risk of obesity and its associated health outcomes. Therefore, while these results are important, they should be considered in the context of a broader, multifactorial approach to understanding and addressing obesity-related cognitive impairments and mental health issues.”

Next, the researchers hope to further explore the mechanisms by which diet-induced obesity affects the brain and behavior by digging deeper into the changes in the gut microbiome and expanding their study to include female mice and different age groups. Wanders added that it would be useful to determine whether weight loss interventions could reverse the impacts.

Reference:

Study suggests obesity contributes to anxiety and cognitive impairment, American Society for Nutrition, Meeting: NUTRITION 2025.

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Early-Life Influences Linked to Rapid BMI Rise and Obesity Risk in Children: Study Finds

USA: A large-scale U.S. study has identified two distinct childhood body mass index (BMI) growth trajectories, highlighting early-life risk factors that could contribute to obesity later in life. The findings, published in JAMA Network Open by Dr. Chang Liu and colleagues from Washington State University, draw attention to the importance of prenatal and early childhood health in curbing the rising tide of childhood obesity.

Analyzing data from 9,483 children enrolled in the NIH-funded Environmental Influences on Child Health Outcomes (ECHO) Program, researchers tracked BMI from ages 1 to 9 and uncovered two primary growth patterns.

The key findings include the following:

  • The majority of children (89.4%) exhibited a typical BMI trajectory, with a slight decline in early years followed by a gradual rise beginning around age six.
  • Approximately 10.6% of children followed an atypical BMI trajectory, maintaining a stable BMI until about age 3.5, after which it rose sharply, reaching an average of 26.2 by age nine, well above the obesity threshold and exceeding the 99th percentile.
  • Maternal smoking during pregnancy was significantly associated with the atypical trajectory (odds ratio [OR] 1.76).
  • High birth weight increased the likelihood of following the atypical BMI pattern (OR 1.40).
  • Excessive gestational weight gain was another identified risk factor (OR 1.26).
  • Preterm birth was linked to a higher risk of atypical BMI development (OR 1.67).
  • High maternal BMI before pregnancy showed a strong association with the atypical, obesity-prone trajectory.

“These results suggest that children showing signs of early rapid BMI increase may benefit from closer monitoring and early intervention,” said Dr. Liu. “Preventing obesity may need to begin before birth—through smoking cessation programs for expectant mothers, healthy pregnancy weight management, and improved prenatal care.”

Childhood obesity, often defined as a BMI at or above the 95th percentile for a child’s age and sex, has been associated with long-term health risks including diabetes, cardiovascular disease, and metabolic disorders. According to the study, children on the atypical growth path were more likely to retain excess weight into adolescence and adulthood if no interventions were made.

The data used in this cohort study spanned from 1997 to 2024 and were gathered from multiple sources, including caregiver reports, clinical records, and direct measurements. The comprehensive approach allowed researchers to model multiphase BMI changes using latent growth mixture modeling—a statistical method suited for detecting variations in growth trends over time.

The authors emphasized that identifying children at risk early on could lead to more effective, personalized strategies to combat obesity. “Our findings point to critical windows for prevention,” Dr. Liu added.

“As the burden of childhood obesity continues to grow, the study calls for a stronger focus on maternal and infant health as part of broader public health strategies,” the authors concluded.

Reference:

Liu C, Chow S, Aris IM, et al. Early-Life Factors and Body Mass Index Trajectories Among Children in the ECHO Cohort. JAMA Netw Open. 2025;8(5):e2511835. doi:10.1001/jamanetworkopen.2025.11835

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Vitamin D deficiency in hip fracture patients associated with increased mortality risk: study

John M. Bayram et al conducted a study to assess whether vitamin D deficiency influenced mortality risk and length of acute hospital stay in patients presenting with a hip fracture. The study has been published in ‘European Journal of Orthopaedic Surgery & Traumatology.’

Vitamin D deficiency is defined by the Endocrine Society Task Force as a serum 25-hydroxyvitamin D [25(OH)D] level < 50 nmol/l. The optimal level is often described as being higher than this with 75 nmol/l as a common target as at this level vitamin D is thought to help prevent fractures.

A retrospective study was undertaken including all patients aged over 50 years that were admitted with a hip fracture to a single centre during a 24-month period. Serum vitamin D levels on admission, patient demographics, perioperative variables and mortality were collected. Cox regression analysis was utilised to determine the independent association between serum vitamin D levels and patient mortality.

Key findings of the study:

• The cohort consisted of 1510 patients with a mean age of 81.3 years and 1107 (71.4%) were female.

• 876 (58.0%) were vitamin D deficient (< 50 nmol/l).

• The median follow up was 405 (IQR 249 to 610) days.

• During follow-up there were 464 deaths (30.7%).

• Vitamin D deficiency was independently associated with higher mortality risk (hazard ratio [HR] 1.26, 95% confidence interval (CI) 1.03 to 1.53, P = 0.022).

• Male sex (HR 1.64, 95% CI 1.34 to 2.01, P < 0.001) was also associated with a higher mortality risk.

• Vitamin D deficiency was not associated with length of hospital stay (median difference 0 days, P = 0.207).

The authors concluded – “Vitamin D deficiency was independently associated with increased mortality in hip fracture patients, though this finding may be influenced by lack of comprehensive adjustment for comorbidity. While the value of routine serum vitamin D measurement is debated, supplementation during hospital stays is important to reduce falls and fracture risks associated with deficiency.” 

Further reading:

Vitamin D deficiency in hip fracture patients is associated with an increased mortality risk

John M. Bayram et al

European Journal of Orthopaedic Surgery & Traumatology (2025) 35:33

https://doi.org/10.1007/s00590-024-04162-8

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Long-COVID Symptoms Differ by Age in Young Children, Study Finds

A study published in JAMA Pediatrics reports that long-COVID symptoms vary by age among young children. Preschoolers (ages 3–5) were more likely to experience dry cough and daytime tiredness or low energy, while babies and toddlers (under 2 years) showed different symptom patterns.

Recent studies have identified characteristic symptom patterns of long COVID (LC) in adults and children older than 5 years. However, LC remains poorly characterized in early childhood. This knowledge gap limits efforts to identify, care for, and prevent LC in this vulnerable population. A study was done to identify symptoms that had the greatest difference in frequency comparing children with a history of SARS-CoV-2 infection to those without, to identify differences in the types of symptoms by age group (infants/toddlers [0-2 years] vs preschool-aged children [3-5 years]), and to derive an index that can be used in research studies to identify young children with LC. This was a multisite longitudinal cohort study with enrollment from over 30 US health care and community settings, including infants, toddlers, and preschool-aged children with and without SARS-CoV-2 infection history. Study data were analyzed from May to December 2024. Results The study included 472 infants/toddlers (mean [SD] age, 12 [9] months; 278 infected with SARS-CoV-2; 194 uninfected; 234 male [50%]; 73 Black or African American [16%]; 198 Hispanic, Latino, or Spanish [43%]; 242 White [52%]) and 539 preschool-aged children (mean [SD] age, 48 [10] months; 399 infected with SARS-CoV-2; 140 uninfected; 277 female [51%]; 70 Black or African American [13%]; 210 Hispanic, Latino, or Spanish [39%]; 287 White [54%]). The median (IQR) time between first infections and completion of symptom surveys was 318 (198-494) days for infants/toddlers and 520 (330-844) days for preschool-aged children. A research index was derived for each age group based on symptoms most associated with infection history. The index is calculated by summing scores assigned to each prolonged symptom that was present, where higher scores indicate greater magnitude of association with history of SARS-CoV-2 infection: poor appetite (5 points), trouble sleeping (3.5 points), wet cough (3.5 points), dry cough (3 points), and stuffy nose (0.5 points) for infants/toddlers, and daytime tiredness/sleepiness/low energy (6.5 points) and dry cough (3 points) for preschool-aged children. Among infants/toddlers with infection, 40 of 278 (14%) were classified as having probable LC by having an index of at least 4 points. Among preschool-aged children, 61 of 399 (15%) were classified as having probable LC by having an index of at least 3 points. Participants with higher indices often had poorer overall health, lower quality of life, and perceived delays in developmental milestones. This cohort study identified symptom patterns and derived research indices that were distinct between the 2 age groups and differed from those previously identified in older ages, demonstrating the need to characterize LC separately across age ranges.

Reference:

Gross RS, Thaweethai T, Salisbury AL, et al. Characterizing Long COVID Symptoms During Early Childhood. JAMA Pediatr. Published online May 27, 2025. doi:10.1001/jamapediatrics.2025.1066

Keywords:

Gross RS, Thaweethai T, Salisbury AL, Characterizing, Long, COVID, Symptoms, During, Early, Childhood, JAMA Pediatrics

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Photogrammetric Systems Outperform Traditional and Intraoral Methods in Impression Accuracy in full-arch dental implant rehabilitation: Study

Researchers have found in a new study that Icam4D and PIC photogrammetric impression systems showed the highest accuracy, surpassing conventional impression techniques in in full-arch dental implant rehabilitation.Further it was found that intraoral scanning method was least accurate.

A study was done to compare the accuracy of photogrammetric imaging, intraoral scanning and conventional impression technique in full-arch dental implant rehabilitation. A resin edentulous mandibular model with six parallel implants was fabricated as master model. And three impression groups were performed: conventional splinted open tray impression technique (CON, n = 10); intraoral scanning technique with 3 Shape scanner (IOS, n = 10; TRIOS3, 3 Shape); digital photogrammetry impression technique with two different photogrammetric system namely PG-1 (Icam4D) and PG-2 (PIC) groups (n = 10). The reference values of master model and test values of CON group were digitized with a laboratory reference scanner, and for all groups the STL files were exported for analyzation. The differences in trueness and precision among the three groups were analyzed using reverse engineering software, focusing on three-dimensional (3D) linearity, angularity, and root mean square (RMS) deviations. Results: For trueness, median deviations (μm) for CON, IOS, PG-1, and PG-2 were 66.05, 78.58, 25.23, and 28.15, with angle deviations of 0.35°, 0.52°, 0.12°, and 0.14°, and RMS deviations (μm) of 40.50, 91.75, 10.87, and 13.35, respectively. Significant differences in X, Y-axis, 3D linearity, angularity, and RMS deviations among groups (p < 0.01). For precision, linear deviations (μm) were 39.32, 45.33, 15.80, and 17.78, with angle deviations of 0.24°, 0.38°, 0.10°, and 0.13°, and RMS deviations (μm) of 36.55, 82.8, 3.7, and 4.6, respectively. Significant differences in X, Y-axis, 3D linearity, XZ-plane, and RMS deviations among groups (p < 0.05). The Icam4D and PIC photogrammetric impression systems exhibited the highest levels of accuracy, followed by conventional impression techniques, whereas intraoral scanning techniques demonstrated the least accuracy.

Reference:

Abuduwaili, K., Huang, R., Song, J. et al. Comparison of photogrammetric imaging, intraoral scanning and conventional impression accuracy of full-arch dental implant rehabilitation: an in vitro study. BMC Oral Health 25, 753 (2025). https://doi.org/10.1186/s12903-025-06029-8

Keywords:

BMC Oral Health, Photogrammetry, Digital impression, Edentulous, Accuracy, Abuduwaili, K., Huang, R., Song, J.

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Age-related genetic changes in blood associated with poor cancer prognosis; Study

Researchers from the Francis Crick Institute, UCL, Gustave Roussy and Memorial Sloan Kettering Cancer Center (MSK), have discovered that expansion of mutant blood cells, a phenomenon linked to ageing, can be found in cancerous tumours, and this is associated with worse outcomes for patients.

Understanding the biological interface of age-related genetic changes and diseases of ageing, such as cancer and cardiovascular disease, is important to develop preventative therapies for a growing proportion of the population.

Clonal haematopoiesis of indeterminate potential (CHIP) is a condition where blood stem cells accumulate mutations over time, influenced by both ageing and external environmental factors. CHIP has already been shown to be associated with risk of age-related disorders, such as cardiovascular disease, but the impact of these genetic changes on solid cancer evolution hasn’t been thoroughly investigated.

Work published today in the New England Journal of Medicine, is a detailed study of the link between CHIP and cancer, in over 400 patients with lung cancer as part of the Cancer Research UK funded TRACERx and PEACE studies, and 49,000 patients with different types of cancer from MSK.

CHIP and cancer prognosis

An initial examination of blood samples allowed the research team to determine which patients had CHIP mutations in their blood. When matched with clinical data, the scientists observed that these mutations were associated with patients living for a shorter period of time, regardless of their age or the stage at which the cancer was diagnosed.

The researchers then went on to study patients with CHIP in more detail and determine whether the specific mutations were also present in their lung tumours because of blood cell infiltration. This was found to be true in 42% of patients with CHIP and they called this phenomenon tumour infiltrating clonal haematopoiesis (TI-CH). The team found that it was TI-CH, not CHIP alone, that was associated with the greater risk of cancer relapse and cancer death.

This finding was supported by samples from the PEACE study, a postmortem investigation of areas where cancer has spread, the main cause of cancer death. The team found that metastatic tumours at these sites often contained TI-CH mutations.

Not all mutations are equal

To inspect the link between TI-CH and poor patient outcomes, the scientists went on to look at the composition of cells in the lung tumours. They found that patients with TI-CH had an expansion of myeloid cells, a type of immune cell. These cells are an important part of the tumour microenvironment and unlike some immune cells that are primed to recognise and fight cancer, myeloid cells have been shown to regulate inflammation and can support tumour progression and spread.

The researchers also discovered that when mutations affected a gene called TET2, which is an important regulator of blood cell production, across thousands of individuals, the TET2 mutant blood cells were more likely to infiltrate the tumour. When analysing hundreds of single cells from the tumours of two patients with TI-CH, they confirmed that TET2 mutations were mostly present in myeloid cells but not in other immune cell types.

The team then collaborated with blood cancer and CHIP experts in a Crick lab led by Dominique Bonnet, to study the impact of TET2 mutations experimentally. Together they grew organoids, mini lung tumours, with TET2 mutant myeloid cells. They showed that TET2 mutant myeloid cells remodelled the tumour microenvironment and accelerated tumour organoid growth.

Looking beyond lung cancer

Finally, in collaboration with researchers at Memorial Sloan Kettering Cancer Center in the US, the team validated their findings using a much larger data set of over 49,000 patients with different types of cancer. Overall, the presence of TI-CH was an independent predictor of shorter survival. But the presence of CHIP and TI-CH varied between cancer types. Researchers found these mutations were more common in cancers known to be harder to treat like lung cancer, head and neck cancer and pancreatic cancer.

The next steps for this work will be to confirm that CHIP directly contributes to cancer outcomes and then detail the exact mechanism by which CHIP is functionally implicated in the development of aggressive cancers.

This work was led by Oriol Pich, Elsa Bernard and Maria Zagorulya.

Oriol Pich, Postdoctoral Project Research Scientist in the Crick’s Cancer Evolution and Genome Instability Laboratory, said: “Our results show that blood cells carrying age-related mutations can infiltrate tumours and impact cancer evolution, leading to worse outcomes for patients.

“This is important because CHIP is a natural phenomenon of ageing that is common in patients with cancer.”

Charlie Swanton, Deputy Clinical Director at the Crick, Chief Clinician at Cancer Research UK and Chief Investigator for TRACERx, said: “This is the first time that we’ve been able to see at scale, the interaction of two different types of ‘clonal proliferations’, age-related CHIP and cancer, providing insight into how ageing might impact cancer risk.

“As we start to piece together the picture of the most important mutations which evolve during the ageing process in cells from the bone marrow, and the impact they have in disease, we hope we can start to identify opportunities for intervention and maybe even prevention of some age-related cancers.”

Reference:

Oriol Pich, Elsa Bernard, Maria Zagorulya, Tumor-Infiltrating Clonal Hematopoiesis, New England Journal of Medicine.

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Oocyte Retrieval Appears Safe for Patients with Higher BMI, Study Finds

According to a study published in Fertility and Sterility, patients with a BMI of 45 or higher had similar assisted reproductive technology (ART) outcomes compared to those with a BMI between 40 and 44.9. These findings suggest that oocyte retrieval can be safely performed in patients with higher BMI levels.

A study was done to compare anesthesia and assisted reproductive technology (ART) outcomes in patients with a body mass index (BMI) of 40–44.9 kg/m2 with those with a BMI of ≥45 kg/m2 because these patients are often excluded from care.

All patients with a BMI of ≥40 kg/m2 undergoing oocyte retrieval for ART from January 2018 to 2023 from one academic fertility clinic and one private fertility clinic. The primary outcome was anesthesia complications at the time of retrieval. Demographic data, cycle specific information, medical comorbidities, BMI at retrieval, length of oocyte retrieval, ART and anesthesia complications, laboratory data, and pregnancy rates were recorded. Results: A total of 98 patients with a BMI of ≥40 kg/m2 undergoing oocyte retrieval were identified for the study: 56 patients with a BMI from 40 to 44.9 kg/m2 and 42 patients with a BMI of ≥45 kg/m2. Demographics were not statistically significantly different between both groups, except that more patients with a BMI of 40–44.9 kg/m2 identified as White (73% vs. 60%) or Black (9% vs. 0). All patients were successfully managed with intravenous sedation and did not require higher level of sedation or care. The mean surgical duration was longer in patients with a BMI of ≥45 kg/m2 than in those with a BMI of 40–44.9 kg/m2 (26.8 minutes [standard deviation, 13 minutes] vs. 22.3 minutes [standard deviation, 8.4 minutes]). Most patients (93%) did not experience any anesthesia complication. The only adverse anesthesia complication in both groups was oxygen desaturation of <90%, which did not differ by cohort even when adjusting for age. There was no difference in the number of mature oocytes retrieved, day 5/6 blastocysts, the number of euploid embryos, or clinical pregnancy, miscarriage, or live birth rates. Body mass index is commonly used as a threshold for access to ART. When using intravenous sedation, patients with a BMI of ≥45 kg/m2 have similar ART outcomes with few anesthesia or ART complications compared with those with a BMI of 40–44.9 kg/m2. With appropriate counseling and preoperative preparation, patients with a BMI of ≥45 kg/m2 can safely undergo oocyte retrieval.

Reference:

Luck M, Rubin E, Garg B, et al. Patients with a body mass index ≥45 kg/m2 can safely undergo oocyte retrievals and anticipate similar assisted reproductive technology outcomes. Fertil Steril. Published online April 19, 2025. doi:10.1016/j.fertnstert.2025.04.014

Keywords:

Reproductive Endocrinology, Oocyte, Retrieval, Appears, Safe, Patient, Higher, BMI, Study, Finds, Obesity, infertility, anesthesia complications, oocyte retrieval, vitro fertilization

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Appendectomy Significantly Reduces Relapse in Ulcerative Colitis Patients, finds study

Researchers have found in a randomized superiority trial that appendectomy, when combined with standard medical therapy, significantly reduced 1-year relapse rates in ulcerative colitis patients in remission compared to medical therapy alone. In the intention-to-treat analysis of nearly 200 patients, the relapse rate was 36% in the appendectomy group versus 56% in the control group (RR 0.65, 95% CI 0.47–0.89, P=0.005; adjusted P=0.002).

The appendix might have an immunomodulatory role in ulcerative colitis. Appendicectomy has been suggested as a potentially therapeutic intervention to maintain remission in ulcerative colitis. We aimed to evaluate the clinical effectiveness of laparoscopic appendicectomy in maintaining remission in patients with ulcerative colitis. They did a pragmatic, open-label, international, randomised controlled superiority trial in 22 centres across the Netherlands, Ireland, and the UK. Patients with established ulcerative colitis who were in remission but had been treated for disease relapse within the preceding 12 months were randomly assigned (1:1) to undergo appendicectomy plus continued maintenance medical therapy (intervention group) or to continue maintenance medical therapy alone (control group). Randomisation was done with a central, computer-generated allocation concealment, stratified by disease extent. Patients and treating physicians were unmasked to group allocation. The prespecified primary outcome was the proportion of patients with a disease relapse within 1 year, predefined as a total Mayo score of 5 or higher with an endoscopic subscore of 2 or 3, or, in absence of endoscopy, based on a centrally independent masked review by a critical event committee as an exacerbation of abdominal symptoms (eg, elevated stool frequency subscore of ≥1 point from baseline) with a rectal bleeding subscore of ≥1 or faecal calprotectin level above 150 μg/g or necessitating treatment intensification other than mesalazine. Analyses were done on an intention-to-treat principle. Findings: Between Sept 20, 2012, and Sept 21, 2022, 1386 patients were screened. 201 patients were randomly assigned to the appendicectomy group (n=101) or the control group (n=100). After exclusion of four patients due to eligibility violations (three had active disease and one received biological agents at time of randomisation), 99 patients in the appendicectomy group and 98 patients in the control group were included in the intention-to-treat analyses. The 1-year relapse rate was significantly lower in the appendicectomy group than in the control group (36 [36%] of 99 patients vs 55 [56%] of 98 patients; relative risk 0·65 [95% CI 0·47–0·89]; p=0·005; adjusted p=0·002). Adverse events occurred in 11 (11%) of 96 patients in the appendicectomy group and 10 (10%) of 101 patients in the control group. The most frequently reported adverse events were postoperative temporary self-limiting abdominal pain in the appendicectomy group (three [3%] patients) and skin rash in the control group (three [3%] patients). Two cases (2%) of low-grade appendiceal mucinous neoplasm were incidentally found in resected appendix specimens in the appendicectomy group. Serious adverse events occurred in two (2%) of 96 patients who underwent appendicectomy and none in the control group. There were no deaths. Appendicectomy is superior to standard medical therapy alone in maintaining remission in patients with ulcerative colitis.

Reference:

Appendicectomy plus standard medical therapy versus standard medical therapy alone for maintenance of remission in ulcerative colitis (ACCURE): a pragmatic, open-label, international, randomised trial. Acherman, Yair I Z et al. The Lancet Gastroenterology & Hepatology, Volume 0, Issue 0

Keywords:

Appendectomy, Significantly, Reduces, Relapse, Ulcerative Colitis, Patients, finds, study, The Lancet Gastroenterology & Hepatology

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