2025

Comprehensive Review on Hair Loss and Restorative Techniques: Advances in Diagnostic, Artistry, and Surgical Innovation (2025)

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Type of publication:

Journal article

Author(s):

Mendoza, Luis A; Ocampo, Genaro G; Abarca-Pineda, Yozahandy A; Ahmad Khan, Mubashir; *Ahmadi, Yasmin; Brown, Najaee; Deowan, Denyse; Nazir, Zahra.

Citation:

Cureus. 17(4):e82991, 2025 Apr.

Abstract:

Hair loss, or alopecia, is a complex disorder that impacts individuals worldwide, frequently resulting in significant psychological and social consequences. This review analyzes the multifactorial etiology, recent diagnostic innovations, and emerging treatment alternatives for hair loss management. Alopecia is classified into the cicatricial (scarring) and non-cicatricial (non-scarring) forms, each having a unique underlying pathogenesis, ranging from autoimmune dysregulation, androgenetic mechanisms, and environmental factors. Recent advancements in diagnostics, such as artificial intelligence (AI)-enhanced imaging and biomarker analysis, have improved precision and individualization of treatment. Novel therapies, such as low-dose oral minoxidil (LDOM), topical 5-alpha reductase inhibitors, and Janus kinase inhibitors (JAKi), offer a range of promising options for hair loss management. Non-invasive therapies, such as low-level laser therapy (LLLT) and platelet-rich plasma (PRP) injections, have demonstrated synergistic benefits with existing treatments. Surgical advancements, especially AI-assisted robotic
follicular unit extraction (FUE), enhance precision and outcomes. Emerging trends in regenerative medicine, especially stem-cell-based therapies and AI integration, are influencing the future of customized hair restoration. This review serves as a comprehensive guide, highlighting the use of innovative technologies and therapies in enhancing the accuracy and customization of hair loss treatment.

DOI: 10.7759/cureus.82991

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Point of View: A Holistic Four-Interface Conceptual Model for Personalizing Shock Resuscitation (2025)

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Type of publication:

Journal article

Author(s):

Rola, Philippe; Kattan, Eduardo; Siuba, Matthew T; Haycock, Korbin; Crager, Sara; Spiegel, Rory; Hockstein, Max; Bhardwaj, Vimal; *Miller, Ashley; Kenny, Jon-Emile; Ospina-Tascon, Gustavo A; Hernandez, Glenn.

Citation:

Journal of Personalized Medicine. 15(5), 2025 May 20.

Abstract:

The resuscitation of a patient in shock is a highly complex endeavor that should go beyond normalizing mean arterial pressure and protocolized fluid loading. We propose a holistic, four-interface conceptual model of shock that we believe can benefit both clinicians at the bedside and researchers. The four circulatory interfaces whose uncoupling results in shock are as follows: the left ventricle to arterial, the arterial to capillary, the capillary to venular, and finally the right ventricle to pulmonary artery. We review the pathophysiology and clinical consequences behind the uncoupling of these interfaces, as well as how to assess them, and propose a strategy for approaching a patient in shock. Bedside assessment of shock may include these critical interfaces in order to avoid hemodynamic incoherence and to focus on microcirculatory restoration rather than simply mean arterial pressure. The purpose of this model is to serve as a mental model for learners as well as a framework for further resuscitation research that incorporates these concepts.

DOI: 10.3390/jpm15050207

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Fabry disease in the haemodialysis population: outcome of a UK screening study (SoFAH) (2014)

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Type of publication:

Journal article

Author(s):

Ng, K P; Sandhu, M; Banerjee, D; Burton, J O; Crowley, L; Doulton, T; Hameed, M A; Hamer, R; Menon, M; *Nicholas, J; Ramakrishna, S B; Shivakumar, K; Geberhiwot, T; Dasgupta, I.

Citation:

BMC Nephrology. 26(1):259, 2025 May 26.

Abstract:

BACKGROUND AND HYPOTHESIS: Fabry disease (FD) is an X-linked inherited disorder with an estimated prevalence among the end-stage kidney disease (ESKD) population of 0.3% in men and 0.1% in women [1]. Due to its non-specific manifestations, FD (especially the later-onset variant) is often underdiagnosed [2]. We aimed to estimate its prevalence in a large haemodialysis (HD) population in the UK.

METHODS: This is a cross-sectional, multicentre study of eight renal centres in the UK. All male participants were tested via dried blood spot alpha-galactosidase A (AG) enzyme and globotriaosylsphingosine (Lyso-Gb3) assays. If either the AG (<= 2.8 micromol/L/H) or Lyso-Gb3 (>= 3.5 ng/mL) level was abnormal, genetic testing for GLA variant was performed. All females had AG, Lyso-GB3 and genetic tests.

RESULTS: In total, 1325 consented to participate in the study. The mean age of the participants was 64 (SD 15) years, 67% were male, 64% were of white ethnicity, the duration of dialysis was 32 (IQR 56) months, and 32% underwent renal biopsy. Diabetic nephropathy (28%) was the most common cause of ESKD, whereas 21% had an unknown aetiology. A total of 1,295 had both AG and Lyso-Gb3 tests, whereas 573 had GLA genetic tests. Among the 14% (n = 186) with an AG level <= 2.8 micromol/L/H, 48 were female and 138 were male, all of whom had Lyso-Gb3 < 3.5 ng/mL. Only 3 (0.2%) had abnormal Lyso-Gb3 but all had normal AG and negative genetic tests. Two females were found to have likely benign, non-pathogenic GLA variants: heterozygous c.937G > T (p.(Asp313Tyr) and heterozygous c.1102G > A (p.(Ala368Thr)).

CONCLUSIONS: Despite the implementation of stringent screening criteria, we did not identify any new confirmed cases of Fabry disease in this large UK haemodialysis population.

DOI: 10.1186/s12882-025-04127-x

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Modification and validation of the Bluebelle Wound Healing Questionnaire (WHQ) for assessing surgical site infection in wounds healing by secondary intention (2025)

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Type of publication:

Journal article

Author(s):

Macefield R.; Mandefield L.; Blazeby J.M.; Fairhurst C.; Baird K.; Arundel C.; Chetter I.; Martin B.C.; Hewitt C.; Gkekas A.; Mott A.; Saramago Goncalves D.P.; Swan S.; Torgerson D.; Wilkinson J.; Zahra S.; Dixon S.; Hatfield J.; Oswald A.; Dumville J.; Lee M.M.; Pinkney T.; Stubbs N.; Wilson L.; Clothier A.; Bosanquet D.; Blow M.; Price C.; Todd J.; Munro T.; Pillay W.; Pradhan A.; Garnham A.; Wall M.; Powezka K.; Gerrard D.; Croucher A.; Hadjievangelou N.; Firth A.; Roe T.; Smith G.; Bicknell C.; Carr C.; Negbenose E.; Tarusan L.; Vesey A.; Wilson D.; Bell D.; Fletcher J.; Greenwood C.; Wallace T.; Vallabhaneni S.; Holder S.; Williams J.; Sim S.; Tambyraja A.L.; Kerray F.; Ng A.; Sylvester M.; Slater L.; Rashid S.T.; Palacios A.; Feld K.; Nandhra S.; Stansby G.; Parr N.; Jones L.; Milne J.; Stubbs C.; Hinchliffe R.; Twine C.; Antoniou G.A.; Corbett C.; Munt S.; Warran S.; Fletcher R.; Al-Jundi W.; Burrows M.; Stather P.; Barnes R.; Woodrow T.; Adams B.; Agu O.; Gleeson Y.; D'Souza R.; Erete L.; *Jones S.; *Checketts C.; *Bajic D.; *Matravers R.; Loftus I.; Budge J.; Azhar B.; Juszczak M.; Syed A.; Hancox R.; Pearce C.; Suggett N.; Whitehouse A.; Kuhan G.; Premnath S.; Dattani N.; Hollings V.; Khasawneh F.; AlShakarchi J.; Packer E.

Citation:

Journal of Tissue Viability. 34(3) (no pagination), 2025. Article Number: 100889. Date of Publication: 01 Aug 2025.

Abstract:

Background: Surgical wounds healing by secondary intention are common. Healing is often complicated by surgical site infection (SSI). SSI assessment is important to guide treatment but existing methods generally require in-person assessment, making them resource intensive. A validated patient-reported SSI outcome measure may be useful to overcome this limitation. Aim(s): To modify and validate the Bluebelle Wound Healing Questionnaire (WHQ) for wounds healing by secondary intention. Method(s): The 18-item Bluebelle WHQ developed for wounds healing by primary intention was modified to make it applicable to secondary healing wounds. Testing was performed as part of the SWHSI-2 randomised trial assessing negative pressure wound dressings versus standard care. Participants completed the WHQ at five timepoints; in-person (baseline, post-healing) and by post (3, 6, 12 months). A reference SSI assessment was performed by a research nurse at the time of wound healing. Acceptability and criterion validity (ability of the Bluebelle WHQ to discriminate between SSI/no SSI) were explored by examining questionnaire return rates, levels of missing data and total score sensitivity/specificity values (receiver operating characteristic curve (ROC)). Result(s): Baseline in-person questionnaire return rates were highest (672/686; 98 %), with postal return rates of 428/615 (68.5 %), 274/416 (65.9 %) and 186/296 (62.8 %) at follow up points. Overall, low levels of item-missing data were observed with few problems completing the questionnaire reported. Ability to discriminate between SSI/no SSI was good (Area under ROC = 0.796). Conclusion(s): The modified Bluebelle WHQ is a valuable tool for post-discharge assessment of wounds healing by secondary intention. It is recommended for use in research and clinical practice.

DOI: 10.1016/j.jtv.2025.100889

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Factors predicting conversion from colon capsule endoscopy to conventional optical endoscopy-findings from the CESCAIL study (2025)

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Type of publication:

Journal article

Author(s):

Lei, Ian Io; Parisi, Ioanna; Bhandare, Anirudh; Perez, Francisco Porras; Lee, Thomas; Shehkar, Chander; McStay, Mary; Anderson, Simon; Watson, Angus; Conlin, Abby; Badreldin, Rawya; Malik, Kamran; Jacob, John; Dixon, Andrew; *Butterworth, Jeffrey; Parsons, Nicholas; Koulaouzidis, Anastasios; Arasaradnam, Ramesh P.

Citation:

BMC Gastroenterology. 25(1):363, 2025 May 13.

Abstract:

BACKGROUND: Colon capsule endoscopy (CCE) has become an alternative to traditional colonoscopy for low-risk patients. However, CCE's low completion rate and inability to take biopsies or remove polyps often result in a CCE-to-conventional colonoscopy conversion (CCC).

OBJECTIVE(S): The aim is to identify the factors that predict issues with bowel cleansing, capsule excretion rates, pathology detection, and the need for CCC.

METHODS: This prospective study analysed data from patients who underwent CCE as part of the CESCAIL study from Nov 2021 till June 2024. Predictive factors were examined for their association with CCC, including patient demographics, comorbidities, medications, and laboratory results from symptomatic and surveillance groups. Statistical methods such as LASSO, linear, and logistic regression were applied.

RESULTS: Six hundred and three participants were analysed. Elevated f-Hb levels (OR = 1.48, 95% CI:1.18-1.86, p = 0.0002) and smoking (OR = 1.44, 95% CI: 1.01-2.11, p = 0.047) were significantly associated with CCC. The area under the curve (AUC) of elevated f-Hb for predicting CCC was 0.62 after adjusting for confounders. Diabetes was linked to poor bowel preparation (OR = 0.40, 95%CI:0.18-0.87, p = 0.022). Alcohol (p = 0.004), smoking (p = 0.003), psychological conditions (p = 0.001), and haemoglobin levels (p = 0.046) were significantly associated with the number of polyps, whilst antidepressants (p = 0.003) and beta-blockers (p = 0.001) were linked to the size of polyps.

CONCLUSION: Non-smokers with lower f-Hb levels are less likely to need conventional colonoscopy (CCC). Patient selection criteria are key to minimising the colonoscopy conversion rate. Our findings would benefit from validation in different populations to develop a robust CCE Conversion Scoring System (CECS) and ultimately improve the cost-effectiveness.

DOI: 10.1186/s12876-025-03828-9

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Robotic Versus Laparoscopic Approaches to Distal Pancreatectomy: Quality Assessment of the Current Evidence (2025)

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Type of publication:

Journal article

Author(s):

*Khan, Attam Ullah; Khan, Adan; Danial, Arbab.

Citation:

JCPSP, Journal of the College of Physicians & Surgeons – Pakistan. 35(5):628-635, 2025 May.

Abstract:

Pancreatic surgery, associated with technical difficulties and high complication rates, remains a challenge for surgeons. The laparoscopic approach has been shown to have benefits over the open approach; however laparoscopic distal pancreatectomy (LDP) still has its challenges. Robotic distal pancreatectomy (RDP) offers a technical edge over the laparoscopic approach in terms of superior imaging and ergonomics. Whether the technical advantages translate into improved outcomes is to be established. The aim of this study was to produce an overview of systematic reviews, summarising the evidence to date comparing RDP and LDP in terms of intraoperative, postoperative, and oncological outcomes and assessing the quality of the included reviews. Three electronic databases, PubMed, Embase, and Scopus, were searched to identify systematic reviews with meta-analyses comparing RDP with LDP. The AMSTAR-2 format was used to assess the quality of the studies. Fourteen systematic reviews were identified for inclusion. RDP had a significantly higher rate of spleen preservation, significantly shorter hospital stay, and a significantly lower rate of conversion to open surgery, whilst having higher total costs compared to LDP. The overall quality of the reviews was variable. The evidence suggests that RDP has potential advantages over LDP in terms of higher spleen preservation rate, shorter hospital stays, and lower conversion rate to open surgery, whilst maintaining comparability with most other outcomes. Based on the variable quality evidence, RDP is a safe alternative to LDP.

DOI: 10.29271/jcpsp.2025.05.628

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Induction of labour versus standard care to prevent shoulder dystocia in fetuses suspected to be large for gestational age in the UK (the Big Baby trial): a multicentre, open-label, randomised controlled trial (2025)

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Type of publication:

Randomised controlled trial

Author(s):

Gardosi, Jason; Ewington, Lauren Jade; Booth, Katie; Bick, Debra; Bouliotis, George; Butler, Emily; *Deshpande, Sanjeev; Ellson, Hanna; Fisher, Joanne; *Gornall, Adam; Lall, Ranjit; Mistry, Hema; Naghdi, Seyran; Petrou, Stavros; Slowther, Anne-Marie; Wood, Sara; Underwood, Martin; Quenby, Siobhan.

Citation:

Lancet. 2025 May 01.

Abstract:

BACKGROUND: The benefits and harms of early induction of labour to reduce shoulder dystocia in fetuses suspected to be large for gestational age (LGA) are uncertain. We aimed to investigate whether early induction of labour is associated with a reduced risk of shoulder dystocia compared with standard care.

METHODS: In this open-label, randomised controlled phase 3 trial, women aged >=18 years with a suspected LGA fetus (estimated fetal weight >90th customised percentile) as identified by ultrasound scan between 35 weeks and 0 days (35+0 weeks) of gestation and 38+0 weeks' gestation, recruited from 106 hospitals across England, Scotland, and Wales in the UK, were randomly assigned (1:1) by web app to standard care or induction of labour between 38+0 weeks' gestation and 38+0 weeks' gestation using minimisation, balancing site, estimated fetal weight percentile (<=95th EFW percentile or >95th EFW percentile), and maternal age (<=35 years or >35 years). Key exclusion criteria included drug-treated diabetes, gestational diabetes, and elective caesarean section or induction already planned or indicated for any reason. Our primary outcome was incidence of shoulder dystocia, assessed by a masked independent expert adjudication panel who reviewed participants' delivery notes. Induction of labour was anticipated to result in birth 10.5 days earlier with a 300 g lower birthweight on average than standard care. We did an intention-to-treat (ITT) analysis in all participants for whom we had primary outcome data, and a per-protocol analysis in participants in the induction group who went into labour or were induced at 38+0 to 38+0 weeks' gestation versus participants in the standard care group who had not started labour, been induced, or had an elective caesarean section before 38+0 weeks' gestation. This study was registered with ISRCTN (18229892) and is no longer recruiting.

FINDINGS: Between June 8, 2018, and Oct 25, 2022, 2893 women were randomly assigned to induction of labour (n=1447) or standard care (n=1446); the trial was terminated before the target of 4000 participants was reached on advice of the data monitoring committee following the lower-than-expected incidence of shoulder dystocia in the standard caregroup. Two participants in the induction group and seven in the standard care group had missing data for the primary outcome and were excluded from the ITT analysis. In the ITT analysis, 33 (2.3%) of 1445 babies in the induction group versus 44 (3.1%) of 1439 in the standard care group had shoulder dystocia (risk ratio [RR] 0.75 [95% CI 0.51-1.09]; p=0.14) with a mean difference of -6.0 days' (95% CI -6.3 to -5.6) gestation and -163.6 g (-190.0 to -137.1) birthweight between trial groups. 355 (24.6%) of 1446 mothers in the standard care group were induced, delivered, or went into labour at or before 38+0 weeks' gestation. In the per-protocol analysis, 27 (2.3%) of 1180 babies in the induction group versus 40 (3.7%) of 1074 in the standard care group had shoulder dystocia (RR 0.62 [0.41-0.92]; p=0.019), and there was a mean difference of -8.1 days' (-8.4 to -7.9) gestation and -213.3 g (-242.0 to -184.6) birthweight between trial groups. One neonatal death occurred from perinatal asphyxia after shoulder dystocia in the standard care group, and one neonatal death occurred following sepsis and congenital pneumonia in the induction group. 88 (6.1%) of 1447 mothers in the induction group had an adverse event versus 108 (7.5%) of 1446 in the standard care group (RR 0.81 [0.62 to 1.06]; p=0.13). Similar numbers of serious adverse events were reported in both groups.

INTERPRETATION: No significant difference in incidence of shoulder dystocia was found between trial groups in the ITT analysis, probably due to the high proportion of earlier-than-expected deliveries in the standard care group reducing the intended between-group differences in gestational age and birthweight. However, in the per-protocol analysis, compared with all deliveries after 38+0 weeks' gestation, induction of labour between 38+0 weeks' gestation and 38+0 weeks' gestation did show a significant reduction in shoulder dystocia. This study provides pregnant women with suspected LGA fetuses and their clinicians important information about choices and decision making for timing and mode of birth.

DOI: 10.1016/ S0140-6736(25)00162-X

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Nigeria introduces the world's first Men5 CV meningitis vaccine (2025)

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Type of publication:

Journal article

Author(s):

Aderinto N.; Olatunji G.; Kokori E.; Ogieuhi I.J.; Alao A.E.; Ajimotokan O.I.; Victoria O.O.; *Akinruli O.A.; Olawoyin M.T.

Citation:

Discover public health. 22(1) (no pagination), 2025. Article Number: 194. Date of Publication: 01 Dec 2025

Abstract:

Meningitis is a serious and potentially life-threatening condition due to inflammation of the brain and spinal cord's meninges. It has various etiologies, among which bacterial meningitis appears to be the most prevalent. Nigeria, the largest country in Africa has now become the first country to roll out a new vaccine called the Men5CV, being able to offer protective against five meningococcal bacterial strains (A, C, W, Y, and X), it offers hope to low-income and developing countries across the world. Clinical trials showed consistent efficacy with minimum adverse effects, and as such it has been approved by the World Health Organization (WHO). 1686 suspected cases were recorded within the last four years in Nigeria, with about 124 confirmed deaths. Despite the success with the MenA conjugate vaccine, other strains still persist. Through a 13-year collaborative effort, there has been significant protection. The rollout of the MEN4CV marks a critical step towards the goal of the WHO in completely eradicating meningitis by 2030. Although challenges like religious reasons and limited vaccine supply exist, we believe with effective training for healthcare practitioners and effective distribution of vaccines to remote areas, these obstacles can be overcome.

DOI: 10.1186/s12982-025-00592-9

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Is this Acute Manifestation of Adrenal Crisis? (2025)

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Type of publication:

Journal article

Author(s):

*Nwaneri C.

Citation:

Acta Medica International. 12(1) (pp 66-71), 2025. Date of Publication: 01 Jan 2025.

Abstract:

Adrenal crisis is a life threatening complication of both primary and secondary adrenocortical insufficiency. The diagnosis of adrenal crisis requires a high index of suspicion, such as circulatory collapse, refractory hypotension, and metabolic acidosis. The clinical features are because of both mineralocorticoid and glucocorticoid deficiencies. The primary and initial treatment is intravenous cortisol therapy, and saline (sometimes glucose). Case presentation was used in this 43 year old woman who presented with dizziness, anorexia, vomiting, generalized weakness, and lethargy. She had a history of recent tuberculosis infection and was commenced on antituberculosis therapy, rifampicin. Her biochemical profile was suggestive of impending adrenal crisis. Her chest X ray and computed tomography were grossly normal. The patient recovered completely and was discharged home with the resolution of her deranged metabolic and electrolyte derangements. Appropriate specialist care is vital in patients with adrenal crisis, coupled with initial aggressive fluid resuscitation and acid base balance and good intensive care.

DOI: 10.4103/amit.amit_89_24

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Cognitive impairment (chemobrain) in early breast cancer patients treated with anthracycline/taxane chemotherapy (2025)

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Type of publication:

Conference abstract

Author(s):

Kenny L.; Vicidomini R.; Wardeh S.A.; Riddle P.; *Pettit L.; Gayani P.; Staples E.; McLeavy L.; Kanwar J.; Edison P.

Citation:

ESMO Open. Conference: Abstract Book of the ESMO Breast Cancer Congress 2025. Munich Germany. 10(Supplement 4) (no pagination), 2025. Article Number: 104998. Date of Publication: 01 May 2025.

Abstract:

Background: Chemotherapy-induced cognitive impairment (CICI) occurs in ~33% of post-chemotherapy breast cancer patients, and is associated with transient or enduring cognitive deficits. However, the aetiology and underlying pathophysiology is yet to be determined. Method(s): 270 early breast cancer patients who received anthracycline (AC/EC) and/or taxane chemotherapy within the previous 12 months were enrolled from UK sites. Clinical and neurocognitive tests were performed on an Artificial Intelligence platform. 18 patients with low cognitive scores, along with 19 controls, underwent further in-person neurocognitive assessments and brain MRI(3T) in Imperial College London. MRI images were analysed using Region of Interest (ROI) and Voxel-Based Morphometric (VBM) analysis. Result(s): The mean age of the patients was 55.6 years (controls=66.7) and average time between initiation of chemotherapy and MRI was 14.1 months. 13/18 received AC/EC-taxanes, 2 received TC, and 3 received taxanes. At the time of MRI, most patients had completed cytotoxic therapy, and 89% were undergoing endocrine therapy. ROI and VBM analyses of CICI patients consistently demonstrated significantly lower grey matter volumes (mm3) and surface areas (mm2) in the following regions: cingulate cortex, medial and orbitofrontal regions of the frontal lobe, precuneus and parietal areas, temporal pole, and lingual cortex. This was associated with poorer semantic, verbal fluency and lower MMSE scores in CICI patients. Conclusion(s): This preliminary data reveals significant cerebral morphological changes and cognitive impairment following anthracycline-taxane chemotherapy. This highlights an urgent need to investigate CICI in a larger cohort of patients to evaluate whether chemotherapy could induce neurodegenerative process so that long-term preventative strategies could be developed.

DOI: 10.1016/j.esmoop.2025.104998

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