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The Growing Success of Medicare Drug-Price Negotiation

Medicare will achieve greater savings on the 15 drugs in its second round of price negotiations than it did in the first round. Despite new challenges, the effort should continue to pay growing dividends.

Treat-to-Target Urate-Lowering Treatment and Cardiovascular Outcomes in Patients With Gout

This cohort study evaluates the association between achieving a serum urate treatment target lower than 6 mg/dL and cardiovascular events among patients with gout who were newly prescribed urate-lowering treatment.

Urate Lowering and Cardiovascular Risk

So far, the main benefit of a treat-to-target (T2T) urate-lowering strategy has been the reduction and, ultimately, the disappearance of gout flares. Robust evidence from randomized trials has demonstrated that achieving and maintaining serum urate (SU) levels below 6 mg/dL (to convert to mmol/L, multiply by 0.0595) for several years markedly reduces the number of flares in patients with gout. So far, the main benefit of a treat-to-target (T2T) urate-lowering strategy has been the reduction and, ultimately, the disappearance of gout flares. Robust evidence from randomized trials has demonstrated that achieving and maintaining serum urate (SU) levels below 6 mg/dL (to convert to mmol/L, multiply by 0.0595) for several years markedly reduces the number of flares in patients with gout.

Inflammatory Knee Osteoarthritis Does Not Improve With Oral Diacerein

Osteoarthritis (OA) of the knee results from deterioration of articular cartilage, often followed by hypertrophy of new bone at the periphery of the joint and synovial inflammation or synovitis. As knee OA progresses into more advanced stages, inflammation and pain prevalence occurs in well over 50%. The pathological development of OA occurs in stages. The cartilage matrix is first broken down by proteolytic enzymes. Matrix fragments are released into joint fluid, which can promote inflammation in the synovial membrane. Inflammation of the synovial membrane creates a vicious cycle, in which the cartilage matrix is further degraded, subsequently provoking more synovial inflammation. Inflammation in knee OA is primarily due to the presence of the cytokine interleukin 1 (IL-1β). This cytokine can stimulate its own production, which increases the synthesis of catabolic factors that degrade cartilage, resulting in chondrocyte apoptosis and decreasing cartilage macromolecule synthesis. Osteoarthritis (OA) of the knee results from deterioration of articular cartilage, often followed by hypertrophy of new bone at the periphery of the joint and synovial inflammation or synovitis. As knee OA progresses into more advanced stages, inflammation and pain prevalence occurs in well over 50%. The pathological development of OA occurs in stages. The cartilage matrix is first broken down by proteolytic enzymes. Matrix fragments are released into joint fluid, which can promote inflammation in the synovial membrane. Inflammation of the synovial membrane creates a vicious cycle, in which the cartilage matrix is further degraded, subsequently provoking more synovial inflammation. Inflammation in knee OA is primarily due to the presence of the cytokine interleukin 1 (IL-1β). This cytokine can stimulate its own production, which increases the synthesis of catabolic factors that degrade cartilage, resulting in chondrocyte apoptosis and decreasing cartilage macromolecule synthesis.

Global Cardiology Societies Team Up to Address Environmental Stressors

This Medical News article discusses a new joint statement from the American College of Cardiology, the American Heart Association, the European Society of Cardiology, and the World Heart Federation addressing the role of environmental risk factors in cardiovascular disease.

Two Trials Comparing Conduction System Pacing and Biventricular Pacing

Cardiac resynchronization therapy (CRT) with biventricular pacing (BiVP) remains a cornerstone treatment for patients with heart failure with reduced ejection fraction and left bundle-branch block (LBBB), supported by decades of randomized evidence demonstrating reductions in mortality and heart failure hospitalization. In parallel, conduction system pacing (CSP), most commonly delivered as left bundle-branch area pacing (LBBAP), has emerged as a physiologically appealing alternative, aiming to directly recruit the His-Purkinje system. Because early observational studies and small randomized trials reported superior electrical resynchronization and larger improvements in left ventricular ejection fraction (LVEF) with CSP than with BiVP, CSP is becoming increasingly popular for CRT in patients who have a strong indication for BiVP. Cardiac resynchronization therapy (CRT) with biventricular pacing (BiVP) remains a cornerstone treatment for patients with heart failure with reduced ejection fraction and left bundle-branch block (LBBB), supported by decades of randomized evidence demonstrating reductions in mortality and heart failure hospitalization. In parallel, conduction system pacing (CSP), most commonly delivered as left bundle-branch area pacing (LBBAP), has emerged as a physiologically appealing alternative, aiming to directly recruit the His-Purkinje system. Because early observational studies and small randomized trials reported superior electrical resynchronization and larger improvements in left ventricular ejection fraction (LVEF) with CSP than with BiVP, CSP is becoming increasingly popular for CRT in patients who have a strong indication for BiVP.

AI in Mental Health Care

This Viewpoint explores the risks associated with using artificial intelligence (AI) in mental health care and how successful risk management would allow both patients and clinicians to experience the benefits of AI in clinical care.

Sivelestat and ARDS After Cardiovascular Surgery

This randomized clinical trial evaluates the efficacy of postoperative sivelestat vs placebo in reducing the incidence of acute respiratory distress syndrome (ARDS) and associated complications among patients undergoing cardiovascular surgery with cardiopulmonary bypass.

Solitary Verrucous Plaque on the Right Pretibial Region

A man in his 50s presented with a 4-month history of pruritic, verrucous lesions on the right lower leg. Physical examination revealed a well-demarcated, verrucous plaque on the right pretibial region, with elevated borders, superficial pustules, exudates, peripheral erythema, and erosion. What is your diagnosis?

Bis-pseudoindoxyls: A new class of single benzene-based fluorophores for bioimaging applications

Fluorophores are chemical compounds or molecules that absorb light energy at one wavelength and re-emit it as light at a longer, lower-energy wavelength, acting as glowing tags or markers. The absorption process is known as excitation, and the re-emission is visible as fluorescent light, which makes these molecules crucial for biological imaging, diagnostics, and tracing cellular molecules like proteins or lipids under normal or various infectious conditions.

Rocks and rolls: The computational infrastructure of earthquakes and physics of planetary science

Sometimes to truly study something up close, you have to take a step back. That's what Andrea Donnellan does. An expert in Earth sciences and seismology, she gets much of her data from a bird's-eye view, studying the planet's surface from the air and space, using the data to make discoveries and deepen understanding about earthquakes and other geological processes.

Why don't antibiotic-making bacteria self-destruct?

Early in 2025, scientists discovered a promising new antibiotic in a soil sample from a lab technician's backyard. The molecule, called lariocidin, is produced by the microbe Paenibacillus and shows broad activity against pathogenic bacteria, including several that are multi-drug-resistant. Now, the researchers report in ACS Infectious Diseases how Paenibacillus avoids harm by its own antibiotic—information that is crucial for developing lariocidin or similar compounds into new drug candidates.

Whether or not US acquires Greenland, the island will be at the center of a massive military build-up in the Arctic

Donald Trump is clearly in a hurry to dominate the political narrative in his second term of office. He began 2026 with strikes in Syria against Islamic State groups, the kidnapping of Venezuelan president Nicolás Maduro, threats to intervene in Iran and the declaration that the US would take control of Greenland—by hook or by crook.

From a new flagship space telescope to lunar exploration, global cooperation will make 2026 an exciting year for space

In 2026, astronauts will travel around the moon for the first time since the Apollo era, powerful new space telescopes will prepare to survey billions of galaxies, and multiple nations will launch missions aimed at finding habitable worlds, water on the moon and clues to how our solar system formed.

Black Ivory coffee: Elephant gut bacteria may contribute to its smooth, chocolaty flavor

Coffee beans that pass through the digestive tracts of animals get their unique flavors from the activity of gut microbes, report researchers from the Institute of Science Tokyo. The guts of Asian elephants that produce Black Ivory coffee (BIC) were rich in pectin-digesting bacteria. Heat-driven degradation of pectin during roasting makes coffee bitter. Bacterial activity that reduces the pectin content of BIC could be the source of its smoother, chocolaty, and less bitter flavor.