This Week In Medicine

This research evaluates whether using smoking duration instead of the current pack-year criteria for U.S. national lung cancer screening could improve equity across different racial and ethnic groups. The study utilized a multi-ethnic cohort to compare the eligibility rates and prognostic performance of the 2021 U.S. Preventive Services Task Force (USPSTF-2021) guidelines against a proposed 30-year smoking duration requirement. The findings indicate that the 30-year duration criteria significantly reduces the screening eligibility disparities between African Americans and Latinos relative to White participants, while also modestly increasing the sensitivity for detecting lung cancer within six years across all groups. Although a risk-based model was also tested and performed well overall, it ultimately widened the eligibility gap for Latino populations, supporting the conclusion that duration-based criteria are a more equitable alternative for lung cancer screening.

NEJM articles:

Volume 393

No. 23

December 11, 2025

This research details a phase 3 randomized clinical trial comparing a novel combination therapy to traditional chemotherapy for patients with HER2-expressing advanced urothelial cancer. The study investigated the efficacy of disitamab vedotin, a HER2-targeting antibody–drug conjugate, combined with the PD-1 immunotherapy toripalimab against standard gemcitabine plus cisplatin or carboplatin. The compelling results showed that the combination therapy significantly extended progression-free survival (13.1 vs. 6.5 months) and overall survival (31.5 vs. 16.9 months) compared to chemotherapy, while also demonstrating a more favorable safety profile with fewer high-grade adverse events. Ultimately, the trial concluded that disitamab vedotin–toripalimab offers a considerable improvement in outcomes for this specific patient population.

NEJM articles:

Volume 393

No. 23

December 11, 2025

This clinical trial investigated whether adding the drug ticagrelor to standard aspirin therapy would improve outcomes for patients who had undergone coronary-artery bypass grafting (CABG) for an acute coronary syndrome. Researchers randomly assigned over 2,200 patients across Nordic centers to receive either the combination therapy or aspirin alone for one year to evaluate a primary outcome that included death, stroke, or heart attack. The results demonstrated that the dual-therapy group did not have a lower incidence of these serious adverse cardiovascular events compared to the aspirin-alone group. Furthermore, the combination of ticagrelor and aspirin was associated with a significantly increased risk of major bleeding, suggesting no clinical benefit for this specific patient population.

NEJM articles:

Volume 393

No. 23

December 11, 2025

The provided text summarizes two distinct, large-scale, randomized controlled trials investigating the effectiveness of the high-dose inactivated influenza vaccine compared to the standard dose in older adults (aged 65 and older). Both studies sought to determine if the high-dose vaccine offered superior protection against severe clinical outcomes, primarily focusing on the composite primary endpoint of hospitalization for influenza or pneumonia. The Danish trial, involving over 330,000 participants, ultimately did not find a significantly lower incidence of this primary outcome with the high dose, although it noted a strong effectiveness against hospitalization specifically for influenza. Conversely, the Spanish trial, which focused on a slightly younger group (ages 65 to 79), concluded that there appeared to be fewer hospitalizations for influenza or pneumonia in those receiving the high-dose vaccine, suggesting conflicting findings regarding overall efficacy against severe complications.

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 New England Journal of Medicine

Hypertonic Saline or Carbocisteine in Bronchiectasis

Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation

Common Diseases in Clinical Cohorts — Not Always What They Seem

Sotatercept for Pulmonary Arterial Hypertension within the First Year after Diagnosis

  Journal of  American Medical Association

Bioresorbable vs Metallic Occluders for Transcatheter Atrial Septal Defect Closure

 Annals of Internal Medicine

Trends in Cancer Incidence in Younger and Older Adults: An International Comparative Analysis

  British Medical Journal

Sodium-glucose cotransporter-2 inhibitors and risk of autoimmune rheumatic diseases

 JAMA oncology 

Risk Factors for Valvulopathy Among Childhood Cancer Survivors

 Gastroenterology

Dietary Fiber Modulates the Window of Susceptibility to Clostridioides difficile Infection

  Clinical Gastroenterology

 Prevalence and Pathophysiology of Loose Stools and Their Impact on Clinical Severity and Quality of Life in Women With Fecal Incontinence

 Clinical Infectious Diseases

Phase 1 Evaluation of VH4524184, a Third-Generation Integrase Strand Transfer Inhibitor With an Enhanced Resistance Profile 

 Journal of Clinical Rheumatology 

A Novel Scoring System for Diagnosing Systemic Lupus Erythematosus–Related Cytopenias: Insights From a Cohort Study

  Circulation

Redefining the Genetic Architecture of Hypertrophic Cardiomyopathy: Role of Intermediate-Effect Variants

 Journals of the American College of Cardiology

Trade-Off Between Bleeding and Ischemic Events From Left Ventricular Assist Devices: A EUROMACS Registry Analysis

 JAMA Cardiology

Age-Stratified Effect of Rivaroxaban Monotherapy for Atrial Fibrillation in Stable Coronary Artery DiseaseA Post Hoc Analysis of the AFIRE Randomized Clinical Trial

  Journal of Clinical Endocrinology & Metabolism

Using a Composite Summary of Daily Sex Hormones to Gauge Time Until Menopause: A Focus on Pregnanediol Glucuronide (PDG)

  Diabetes care

Differential Effect of GLP-1 Receptor Agonists and SGLT2 Inhibitors on Lower-Extremity Amputation Outcomes in Type 2 Diabetes: A Nationwide Retrospective Cohort Study

  Neurology

Soccer Heading Exposure–Dependent Microstructural Injury at Depths of Sulci in Adult Amateur Players

  Chest

Effect of Ventilator Mode on Ventilator-Free Days in Critically Ill Adults

Clinical Journal of American Society of Nephrology

Comparative Effectiveness of Lubiprostone and Stool Softeners on Risk of Kidney Outcomes in Patients with CKD

Kidney International reports

Randomized Trial of Dapagliflozin in Patients With Nondiabetic Stage 4 CKD

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 New England Journal of Medicine

Sentinel-Lymph-Node Biopsy Alone or with Lymphadenectomy in Cervical Cancer

A Phase 3 Trial of Telitacicept for Systemic Lupus Erythematosus

Long-Term Safety and Efficacy of Gene Therapy for Adenosine Deaminase Deficiency

Mass Administration of Azithromycin to Infants in Mali to Reduce Mortality

  Journal of  American Medical Association

Intra-Arterial Alteplase After Successful Endovascular Reperfusion in Acute Stroke

The PEARL Randomized Clinical Trial

Annals of Internal Medicine

Effectiveness of Recombinant Herpes Zoster Vaccine in the U.S. Medicare Population, 2018 to 2019, by Immunocompetence and Prior Receipt of Live Zoster Vaccine

 British Medical Journal

Sodium-glucose cotransporter-2 inhibitors and risk of autoimmune rheumatic diseases: population based cohort study

  Lancet

The global, regional, and national burden of cancer, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023

 JAMA oncology 

Pathogenic Variants, Family History, and Cumulative Risk of Breast Cancer in US Women

  Gastroenterology

Efficacy of ACupuncTure in Irritable bOwel syNdrome (ACTION): A Multicenter Randomized Controlled Trial

  Clinical Gastroenterology

Safety and Efficacy of Endoscopic Submucosal Dissection for Rectal Neoplasms Extending to the Dentate Line: A Systematic Review and Meta-analysis

  Clinical Infectious Diseases

Dolutegravir/Lamivudine for Maintenance of Virological Suppression in Persons With Historical Suspected or Confirmed Resistance to Lamivudine: Week 48 Results of a Single-Arm, Open-Label, Multicenter, Phase IIa Clinical Trial

  Journal of Clinical Rheumatology 

Knowledge and Behaviors in Reproductive Health Among Mexican Women With Autoimmune Rheumatic Diseases: Cross-sectional Study

  Circulation

Contemporary Burden of Cardiovascular Disease in Pregnancy: Insights From a Real-World Pregnancy Electronic Health Record Cohort

  Journals of the American College of Cardiology

Clonal Hematopoiesis and Cardiovascular Outcomes in Older Women

 JAMA Cardiology

Efficacy and Tolerability of Finerenone According to the Use and Dosage of DiureticsA Prespecified Analysis of the FINEARTS-HF Randomized Clinical Trial

 Journal of Clinical Endocrinology & Metabolism

Evaluation of Aldosterone Suppression by Cinnarizine, a Putative Cav1.3 Inhibitor 

 Chest

The Association Between Mechanical Power Within the First 24 Hours and ICU Mortality in Mechanically Ventilated Adult Patients With Acute Hypoxemic Respiratory Failure

 The American Journal of Respiratory and Critical Care Medicine

One-Year Change in Quantitative Computed Tomography Is Associated with Meaningful Outcomes in Fibrotic Lung Disease

 Clinical Journal of American Society of Nephrology

The Association of Long COVID and CKD: Findings from the National Clinical Cohort Collaborative

 Kidney International reports

Effects of Combination Treatment on Renal Endothelial Function in Type 2 Diabetes Mellitus

Here are the  articles   from Kidney International reports

A New Prognostic Score Based on Cell-Mediated Immunity for Cytomegalovirus Infection After Transplantation

Introduction

The interferon gamma (IFN-γ) enzyme-linked immunosorbent spot is a highly sensitive immune assay that enables the assessment of cytomegalovirus (CMV)-specific cell-mediated immunity (CMI) and can identify at-risk transplant patients of CMV infection; however, its clinical implementation remains elusive.

Conclusion

We developed a robust CMV-PrognosTIC score to quantify the risk of CMV infection in SOT, which may be readily implemented in clinical transplantation to personalize CMV preventive therapies.

Self-Reported Outcome of Living Kidney Donation Correlates With Perioperative Complications not With Surgical Techniques

Introduction

The German health care system lacks data on surgical complications and self-reported outcomes (SROs) of living donors. The prospective German Living Kidney Donor Registry, SOLKID-GNR aims to improve the assessment of donors’ medical and psychosocial risks.

Conclusion

Although the surgical technique does not directly affect donors' QoL shortly after donation, minimally invasive procedures result in shorter hospital stays and a quicker return to work. Self-reported complications have a greater impact on mental QoL than those documented by transplant centers, highlighting the importance of subjective experiences during recovery.

Hi, This Week in Medicine, we will be discussing

First we will be discussing articles in New England Journal of Medicine

Low-Dose Aspirin for PI3K-Altered Localized Colorectal Cancer

Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes

Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity

Proportional-Assist Ventilation for Minimizing the Duration of Mechanical Ventilation

  Journal of  American Medical Association

Prediction of Platelet Transfusion Outcomes in Preterm Infants With Severe Thrombocytopenia

  Annals of Internal Medicine

The Cost-Effectiveness of Semaglutide and Tirzepatide for Patients With Knee Osteoarthritis and Obesity

 British Medical Journal

Second cancers in 475 000 women with early invasive breast cancer diagnosed in England during 1993-2016

 Lancet

Paclitaxel-coated versus uncoated devices for infrainguinal endovascular revascularisation in patients with intermittent claudication (SWEDEPAD 2): a multicentre, participant-masked, registry-based, randomised controlled trial

  JAMA oncology 

Established Cancer Predisposition Genes in Single and Multiple Cancer Diagnoses

Falls Among Individuals With Systemic Lupus Erythematosus: An Observational Study

Journals of the American College of Cardiology

Safety and Effectiveness of Statins for Primary Prevention in Adults With Type 1 Diabetes: An Emulation

  JAMA Cardiology

One-Year Outcomes of Coronary Angiography After Out-of-Hospital Cardiac Arrest Without ST ElevationAn Individual Patient Data Meta-Analysis

 Journal of Clinical Endocrinology & Metabolism

Association Between Urinary Phthalate Metabolites and Sarcopenia in US Adults From NHANES 2011-2018

 Diabetes care

A Multimodal Predictive Model for Chronic Kidney Disease and Its Association With Vascular Complications in Patients With Type 2 Diabetes: Model Development and Validation Study in South Korea and the U.K. 

  Neurology

Association of Increase in White Matter Hyperintensity Volume With Rate of Hippocampal Atrophy in a Population-Based Study of Aging

  Chest

Investigating the Long-Term Effects of COVID-19 Infection on Health Care Utilization in Individuals With COPD

 The American Journal of Respiratory and Critical Care Medicine

Molecular Phenotyping of Sepsis and Differential Response to Fluid Resuscitation

 Clinical Journal of American Society of Nephrology

Sodium-Glucose Cotransporter 2 Inhibition and Hospitalizations in Patients with CKD: A Meta-Analysis of Kidney Outcome Trials

Kidney International reports

Prospective Pilot Study of Plasma Cell–Targeted Therapy With Bortezomib in Refractory IgA Nephropathy

Community-Acquired Acute Kidney Injury and Late Kidney Dysfunction in Survivors of COVID-19 Hospitalization

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 New England Journal of Medicine

Aficamten or Metoprolol Monotherapy for Obstructive Hypertrophic Cardiomyopathy

Mavacamten in Symptomatic Nonobstructive Hypertrophic Cardiomyopathy

Multidomain Rehabilitation for Older Patients with Myocardial Infarction

  Journal of  American Medical Association

Biparametric vs Multiparametric MRI for Prostate Cancer Diagnosis

The PRIME Diagnostic Clinical Trial

  Annals of Internal Medicine

Exposure to CT and Pregnancy Outcomes

  British Medical Journal

Second cancers in 475 000 women with early invasive breast cancer diagnosed in England during 1993-2016 

 Lancet

Benefit–harm trade-offs of intensive blood pressure control versus standard blood pressure control on cardiovascular and renal outcomes: an individual participant data analysis of randomised controlled trials

JAMA oncology 

Debt, Bankruptcy, and Credit Scores After Cancer Diagnosis

  Journal of Clinical Rheumatology 

Pilot Study: Development and Evaluation of Validity Evidence of a Low-Cost, Low-Fidelity Hand Model to Teach Clinical Assessment of Small Joint Swelling in Inflammatory Arthritis

  Journals of the American College of Cardiology

Trajectories of Angina After Initial Invasive vs Conservative Strategy for Chronic Coronary Disease

 JAMA Cardiology

Polygenic Prediction of Peripheral Artery Disease and Major Adverse Limb Events

  Journal of Clinical Endocrinology & Metabolism

YAP1 Is a Prognostic Marker and Its Inhibition Reduces Tumor Progression in Adrenocortical Tumors

 Diabetes care

Glucagon-Like Peptide 1 Receptor Agonists and the Risk of Emergency Department Visits and Hospitalization in Patients With Chronic Kidney Disease 

  Neurology

Association of Polygenic Susceptibility to Hyperlipidemia With Cholesterol Control and Recurrent Stroke in Ischemic Stroke Survivors

   Chest

Association of Timely Spirometry With Lower All-Cause Mortality

 Risk Factors for Patient-Important Upper Gastrointestinal Bleeding 

Clinical Journal of American Society of Nephrology

Pregnancy and Long-Term Kidney Function in CKD: A Systematic Review and Meta-Analysis

 Kidney International reports

Meta-Analysis of Randomized Controlled Trials on Gamma-Aminobutyric Acid Analogues and Opioid-Based Therapies for CKD-Associated Pruritus

A Systematic Review of Sleep Hygiene Strategy in CKD

Hi, This Week in Medicine, we will be discussing

First we will be discussing articles in New England Journal of Medicine

Overall Survival with Neoadjuvant Nivolumab plus Chemotherapy in Lung Cancer

Elinzanetant for Vasomotor Symptoms from Endocrine Therapy for Breast Cancer

Phase 3 Trial of Inhaled Molgramostim in Autoimmune Pulmonary Alveolar Proteinosis

Adjuvant Cemiplimab or Placebo in High-Risk Cutaneous Squamous-Cell Carcinoma

  Journal of  American Medical Association

 Annals of Internal Medicine

Measurement Error and the Cost-Effectiveness of Intensive Blood Pressure Targets

Effect of lateral versus supine positioning on hypoxaemia in sedated adults

 Lancet

Spironolactone versus placebo in patients undergoing maintenance dialysis (ACHIEVE): an international, parallel-group, randomised controlled trial

 JAMA oncology 

Sintilimab Plus Axitinib for Advanced Fumarate Hydratase–Deficient Renal Cell CarcinomaA Phase 2 Nonrandomized Clinical Trial

  Clinical Infectious Diseases

  Journal of Clinical Rheumatology 

Noninfectious Uveitis in Pediatric Rheumatology: Long-term Follow-up at Tertiary Centers

 Circulation

A Nationwide Factorial Randomized Trial of Electronic Nudges to Patients With Chronic Kidney Disease and Their General Practices for Increasing Guideline-Directed Medical Therapy: The NUDGE-CKD Trial

  Journals of the American College of Cardiology

Paclitaxel-Coated Balloon for the Treatment of Multilayer In-Stent Restenosis: AGENT IDE Subgroup Analysis

 JAMA Cardiology

Polygenic Prediction of Peripheral Artery Disease and Major Adverse Limb Events

 Journal of Clinical Endocrinology & Metabolism

Association Between Urinary Phthalate Metabolites and Sarcopenia in US Adults From NHANES 2011-2018

 Diabetes care

In Utero Exposure to Maternal Hyperglycemia and Offspring Type 2 Diabetes Genetic Risk Score Are Independently Associated With Risk of Impaired Glucose Tolerance in Youth 

  Neurology

Use of Disease-Modifying Therapies in Patients With Late-Onset Multiple    Chest

Normosol-R vs Lactated Ringers in the Critically Ill

  The American Journal of Respiratory and Critical Care Medicine

Mechanically Affected Lung and Progression of Emphysema

  Clinical Journal of American Society of Nephrology

Population Health Management Impact on Healthcare Utilization and Costs in CKD: Post Hoc Analysis of the Kidney Coordinated HeAlth Management Partnership Trial

Sex Differences in the EXerCise Introduction to Enhance Performance in Dialysis Trial

 Kidney International reports

Economic Evaluation of System-Wide Implementation of Kidney Supportive Care

Impact of Improved Diagnosis and Treatment on Holistic CKD Burden