Search Medical Journals & Research Articles

[Viewpoint] Sustainable anticoagulation for climate resilient care

This Viewpoint issues a multidisciplinary call to embed sustainability into anticoagulation care, aligning clinical excellence with climate responsibility. Anticoagulation management—including drug manufacturing, laboratory diagnostics, therapeutic monitoring, and long-term follow-up—contributes substantially to health-care-associated carbon emissions. We propose a systems-level decarbonisation strategy, anchored in life cycle assessment methodology, to quantify emissions across anticoagulation care and identify high-impact intervention points.

[Review] Von Willebrand factor and von Willebrand disease in ageing: mechanisms, evolving phenotypes, and clinical implications

The global population is ageing and this demographic shift has profound effects on haemostasis, notably a progressive tilt towards a hypercoagulable state. A major age-associated change in haemostasis is the increase in von Willebrand factor (VWF), a plasma glycoprotein essential for primary and secondary haemostasis. VWF deficiency causes von Willebrand disease, which is the most common inherited bleeding disorder and affects approximately 1% of the population. Conversely, elevated VWF concentrations are linked to increased thrombotic risk; VWF concentrations increase with age by approximately 10–15 IU/dL per decade.

[Articles] Patient-reported outcomes with belantamab mafodotin, pomalidomide, and dexamethasone versus bortezomib, pomalidomide, and dexamethasone in patients with relapsed or refractory multiple myeloma (DREAMM-8): a phase 3, open-label, randomised controlled trial

Patients with relapsed or refractory multiple myeloma treated with belantamab mafodotin, pomalidomide, and dexamethasone or bortezomib, pomalidomide, and dexamethasone reported stable HRQOL. Self-reported ocular adverse events were generally manageable and minimally bothersome within the first year of treatment. These findings indicate that belantamab mafodotin, pomalidomide, and dexamethasone is well tolerated, with little detriment to HRQOL, supporting its use in relapsed or refractory multiple myeloma.

[In Focus] Perspectives of potential haematopoietic stem-cell donors on education TikToks

TikTok is a rapidly growing social media platform on which users develop, interact with, or share short vertical videos (TikToks). Although TikToks have immense potential to be harnessed to affect health knowledge, attitudes, and behaviours, little research guides TikToks’ potential public health applications. Since 2020, we have led the development and use of a large TikTok library to engage diverse young adults to haematopoietic stem-cell donation. This library, including hundreds of TikToks starring diverse performers, has generated hundreds of thousands of views and engagements across social media platforms.

[In Focus] Incorporating national disease burden in GBD estimates of haemoglobinopathies in Italy

The Global Burden of Disease (GBD) study represents an incredible source of information to quantify and understand the magnitude and impact of all conditions, including common and rare diseases, on patients’ quality of life, mortality, and morbidity. Emerging evidence suggests that detailed national studies are needed to inform, calibrate, and validate GBD estimates. This need is also supported by action on local GBD network, such as the Italian GBD network, cross-talking with the global GBD network.

[Comment] Cytokine-engineered CAR T-cell therapy in relapsed or refractory B-cell acute lymphoblastic leukaemia

Anti-CD19 CAR T-cell therapy has established a new standard of care for children and adults with relapsed or refractory B-cell acute lymphoblastic leukaemia (r/r B-ALL), culminating in the regulatory approval of three products associated with high rates of remission.1–3 However, the promise of currently available commercial CAR T-cell agents has been constrained by the loss of CAR persistence, resulting in suboptimal durability and high rates of CD19-positive relapse. Innovative approaches to circumvent this limitation include the development of armoured CAR T cells, in which the T cells are engineered to secrete immunomodulatory cytokines.

[Comment] Can ropeginterferon SURPASS resistance in essential thrombocythaemia?

Essential thrombocythaemia is a clonal myeloproliferative neoplasm associated with a lifelong risk of arterial and venous thrombosis, haemorrhage, and disease progression to secondary myelofibrosis and acute leukaemia.1 Current management strategies are primarily guided by the estimated risk of thrombotic events, presence of extreme leukocytosis or thrombocytosis, and disease-related symptoms. Hydroxyurea remains the most widely used first-line cytoreductive therapy for essential thrombocythaemia.

[Editorial] New hope, old challenges in myelodysplastic syndromes

Myelodysplastic syndromes are a complex and heterogenous group of clonal myeloid neoplasms, characterised by ineffective haematopoiesis, diverse cytopenias, and the risk of progression to acute myeloid leukaemia. Since being identified as a distinct disease in the late 1970s, the journey towards understanding, classifying, and treating myelodysplastic syndromes has been arduous, marked by major advances, yet still hampered by persistent challenges. Today patients with myelodysplastic syndromes continue to face low long-term survival, with a 5-year overall survival rate of approximately 37%, and no curative treatments outside haematopoietic stem-cell transplantation.

The Growing Promise of Elinzanetant for Treatment of Menopausal Symptoms

Vasomotor symptoms (VMS) and sleep disturbances are common menopause symptoms and adversely affect menopause-related quality of life. Menopause occurs between ages 45 and 56 years for 90% of women in the US. Growing evidence suggests that VMS and primary insomnia in menopause are driven, at least in part, by the effect of declining estrogen levels on the thermoregulatory function of the hypothalamus. Research has elucidated major roles of hypothalamic kisspeptin/neurokinin (NK) B/dynorphin (known as KNDy neurons), which express NK-1 and NK-3 receptors and their ligands (including NKB).

Hormone Therapy for Menopausal Vasomotor Symptoms

Vasomotor symptoms (VMS) such as hot flashes and night sweats are common in menopausal women and severely impact quality of life in many. Hormone therapy (HT) is the most effective treatment for VMS, but there has been debate for years about its cardiovascular safety. In this issue of JAMA Internal Medicine, Rossouw et al provide updated analyses of data from the Women’s Health Initiative (WHI) randomized clinical trials to assess the safety of HT for treatment of menopausal VMS. The WHI trials, perhaps the most well-known studies ever completed in women’s health, were designed to address whether treatment with estrogen or estrogen plus a progestin could reduce the risk of coronary heart disease (CHD) in older women. The trials were not designed to evaluate the effect of HT on menopausal VMS. The WHI trials of both HT formulations were stopped early due to harm, which resulted in a marked reduction in the use of HT. Prior post hoc analyses of WHI data and other studies have suggested an important effect of age on risk for adverse CHD events, with HT not increasing risk of CHD in younger postmenopausal women (those aged 50 to 59 years); thus, HT might remain a safe first line treatment for VMS in women in this age group.

Reducing Early Stroke Recurrence Risk—Beyond Antithrombotics

About one-third of persons with ischemic strokes have diabetes, and an additional one-third have insulin resistance. After an ischemic stroke, diabetes is associated with approximately 20% higher risk of mortality, rehospitalizations, and ischemic stroke recurrence. Diabetes often occurs in the context of metabolic syndrome, obesity, hypertension, and dyslipidemia, which further compounds risk of downstream major cardiovascular adverse events. While treatments for dyslipidemia and hypertension have shown consistent reduction in cardiovascular events, clinical trials treating hyperglycemia were less consistent in demonstrating reduction of cardiovascular events. By addressing both hyperglycemia and weight management, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may have greater cardiovascular benefits than other glucose-lowering agents.

Still Searching for the Right Intervention to Improve Transitions of Care for Patients With Heart Failure

In this issue of JAMA Internal Medicine, Masterson Creber et al present the results of the Mighty-Heart randomized clinical trial, which compares 2 transitional care interventions delivered to patients discharged home after a heart failure hospitalization. Participants were randomized to receive a care coordination telephone call from a health system nurse within 48 to 72 hours after discharge or the same telephone call plus a mobile integrated health program that consisted of ongoing nurse care coordination and the availability of community paramedic home visits and telehealth visits with emergency medicine physicians (arranged by the nurse). Among 2003 participants recruited from 11 hospitals in New York, New York, there were no differences between the study groups in the coprimary outcomes of the Kansas City Cardiomyopathy Questionnaire overall summary score or 30-day all-cause hospital readmission, with one-fifth of participants in both groups readmitted within 30 days.

[Articles] Examination of self-harm clustering in adolescent peer networks: a nationwide registry cohort study in Finland

While we cannot rule out residual confounding, our findings suggest that self-harm may socially transmit within adolescent peer networks. The observed highest risk around age 16 suggests that external stressors associated with transitioning to new life stages at this age may moderate the impact of peer self-harm exposure. Prevention and intervention measures that consider possible peer influences on adolescents’ self-harming behaviour may help reduce the public health burden of self-harm.

[Articles] Brand-specific influenza vaccine effectiveness in three Nordic countries during the 2024–2025 season: a target trial emulation study based on registry data

Seasonal influenza vaccines moderately reduced the risk of severe outcomes in older adults. Efluelda Tetra and Fluad Tetra appeared to offer favourable protection in their respective target groups, supporting their use in the 2025/2026 season. Annual monitoring using Nordic registries is crucial for informing evidence-based vaccination strategies and regulatory decisions.

[Correspondence] HPV vaccine introduction in Pakistan: a strategic opportunity for multisectoral alliance

Pakistan has achieved a major public health milestone with the rollout of the human papillomavirus (HPV) vaccine in September 2025. This has been a long-awaited intervention for cervical cancer prevention, with an FDA-approved vaccine since 2006 that has been successfully rolled out in 144 countries.1,2 Globally, approximately 662,301 women were diagnosed with cervical cancer, and 348,874 died from the disease in 2022.3 In Pakistan, there were 5008 women diagnosed with cervical cancer, and 3197 lost their lives (Globocan 2022).