Author: Jason Curtis

Improving Documentation on Paediatric Inpatient Drug Charts (2025)

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Type of publication:

Service improvement case study

Author(s):

*Dima Abdelhafiz, *Caitlyn Randles

Citation:

SaTH Improvement Hub, November 2025

SMART Aim:

I will improve the accuracy and completeness of weight documentation on paediatric drug cards by 30/09/25 as evidenced by a two cycle quality improvement project which shows an improvement in clear and accurate weight documentation on paediatric drug charts.

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NHS blood and transplant donor echocardiography standard to improve organ utilisation in heart transplantation (2025)

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Type of publication:

Journal article

Author(s):

Akhtar W; Peck M; *Miller A; Billyard T; Goedvolk C; Ryan M; Soliman Aboumarie H; Gil FR; Berman M; Rubino A

Citation:

The Journal of the Intensive Care Society. 17511437251394267, 2025 Nov 15.

Abstract:

Focused echocardiography plays a vital role in assessing donor hearts and improving donor utilisation in the United Kingdom. A NHS Blood & Transplant working group was established and, through a review of the current evidence and modified Delphi approach, developed guidance for a minimum dataset for image acquisition in donor heart assessment. This is in intended as a pragmatic optional supplementation to current focused echocardiography protocols. We present a donor echocardiography proforma with accompanying educational materials for use in the United Kingdom.

DOI: 10.1177/17511437251394267

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Systemic Therapies for Moderate-to-Severe Atopic Dermatitis in Children and Adolescents: A Systematic Review (2025)

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Type of publication:

Systematic Review

Author(s):

Hamza Osman, Sahar Khalil; *Mohamed Ahmed, Malaz Awad; Idrees, Hoda; Mohammad Ali, Aziza Mohammad Hassan; Ahmed Taha, Aisha Hassan; Musa Shaikhelsafi, Fatima Hassan; Mirghani Hamour, Afrah Mohamed.

Citation:

Cureus. 17(10):e94907, 2025 Oct.

Abstract:

Moderate-to-severe atopic dermatitis (AD) in children and adolescents imposes a significant burden, often requiring systemic therapy. With the recent development of targeted biologics and Janus kinase (JAK) inhibitors, the treatment landscape has evolved rapidly. This systematic review aims to critically evaluate the efficacy and safety of these advanced systemic therapies in the pediatric population. A systematic search of PubMed/MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov was conducted for randomized controlled trials (RCTs) published from 2020 onwards, yielding 250 records. Thirteen studies involving over 3,500 pediatric patients were included. Studies evaluating biologics or JAK inhibitors in children and adolescents (0-18 years) with moderate-to-severe AD were included. The Cochrane Risk of Bias 2 (ROB 2) tool was used for quality assessment. A narrative synthesis was performed due to clinical heterogeneity. Dupilumab and tralokinumab (biologics) demonstrated significant efficacy, with Eczema Area and Severity Index 75 (EASI-75) response rates of 43.3% at week 16 and sustained improvements in disease severity (SCORAD, IGA) and pruritus. The JAK inhibitors, abrocitinib and upadacitinib, showed rapid and high-magnitude efficacy, with EASI-75 and Validated Investigator Global Assessment (vIGA-AD) response rates frequently exceeding 70-90% by weeks 12-16 and providing rapid itch relief. Dupilumab's safety profile was favorable, with mostly mild-to-moderate adverse events (e.g., conjunctivitis). JAK inhibitors were associated with acne, nausea (abrocitinib), and herpes infections, necessitating routine monitoring. The overall risk of bias was low across most studies. Advanced systemic therapies are highly effective for moderate-to-severe pediatric AD. Biologics offer a well-established safety profile, while JAK inhibitors provide superior and faster efficacy, particularly for itch, but require careful safety monitoring. Treatment choice should be individualized based on disease severity, preference, and risk profile.

DOI: 10.7759/cureus.94907

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Atezolizumab-Induced Thyroiditis and Immune Checkpoint Inhibitor (ICI)-Type 1 Diabetes Mellitus: Diagnostic and Therapeutic Challenges in ICI-Associated Endocrinopathies (2025)

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Type of publication:

Journal article

Author(s):

*Al-Rubaye, Rafal; *Nadeem, Sabha; Soliman, Ahmed Abdulkader Zaki Ali.

Citation:

Cureus. 17(10):e94593, 2025 Oct.

Abstract:

The rapid evolution and increased application of immune checkpoint inhibitors (ICIs) in the oncology setting have introduced novel diagnostic and therapeutic challenges, particularly in the setting of endocrine immune-related adverse events (irAEs). Thyroid dysfunction is among the most common of these, while ICI-type 1 diabetes mellitus is uncommon and can present abruptly with life-threatening complications. A 76-year-old man with extensive-stage small-cell lung cancer being treated with atezolizumab developed new-onset diabetes, which manifested as diabetic ketoacidosis in connection with immunotherapy-induced thyroiditis. Metabolic instability in this patient was compounded by the inappropriate initiation of thyroid hormone replacement during the thyrotoxic phase of the thyroiditis as a result of misinterpretation of his thyroid function tests (TFTs). The unique clinical course of this patient illustrates the broad and unpredictable spectrum of ICI-related endocrinopathies and highlights the importance of prudent interpretation of TFTs, early recognition of ICI-induced type 1 diabetes mellitus, and close multidisciplinary management of irAEs.

DOI: 10.7759/cureus.94593

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Risk of major adverse cardiovascular events in Crohn's disease patients treated with biologic therapy: A meta-analysis and trial sequential analysis of randomised controlled trials (2025)

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Type of publication:

Conference abstract

Author(s):

Bharadwaj H.; Perros I.; Biggs D.; *Butterworth J.; Gohar F.; Sokhal B.S.; Mallen C.

Citation:

United European Gastroenterology Journal. Conference: The 33rd United European Gastroenterology Week, UEGW 2025. Berlin Germany. 13(Supplement_8) (pp 628), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Biologic therapies are the preferred treatment for induction and maintenance of remission in Crohn's Disease, although their cardiovascular safety remains uncertain. This systematic review and meta-analysis aimed to estimate the risk of major adverse cerebrovascular and cardiovascular events (MACCEs) in adult CD patients receiving biologic or small molecule therapies in randomised controlled trials (RCTs). Aims & Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE, EMBASE, and Cochrane were searched to identify RCTs that assessed the risk of MACCEs in CD induction and maintenance trials. Data were pooled and analysed using random effects modelling with 95% confidence intervals (CIs). Result(s): 40 RCTs were included, describing 20 induction and 20 maintenance trials. A total of 17,718 patients were included, with 11,148 (62.9%) receiving biologic agents or small molecules. The risk of MACCEs was lower in induction (OR=0.56, 95%CI: 0.24,1.34, P=0.19) and maintenance trials (OR=0.75, 95%CI: 0.35,1.57, P=0.44) compared to placebo or active comparators. MACCE risk remained unaffected by drug agent, drug class, and trial duration. Overall, there was no difference in MACCE risk based on receipt of biological therapy (OR=0.65, 95%CI: 0.37,1.15, P=0.14). Conclusion(s): Biologic agents and small molecules did not increase MACCE risk in CD induction and maintenance trials. A slight cardioprotective effect was observed. Longer follow-up studies with real-world data are required to confirm these findings outside the RCT setting.

DOI: 10.1002/ueg2.70032

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