2 Minute Medicine

1. A comparative evaluation tested five publicly available LLMs on 2044 oncology questions, covering comprehensive topics in the field. The responses were compared to a human benchmark. 2. Only one of the five models tested performed above the 50 th percentile, with worse performance observed in clinical oncology subcategories and female-predominant malignancies. Evidence Rating Level: 2 (Good) Study Rundown: Many medical professionals have begun to use large language models (LLMs), such as ChatGPT, as augmented search engines for medical information...

1. Post-traumatic stress disorder (PTSD) symptoms were associated with higher levels of chronic pain, pain catastrophizing, and pain interference amongst U.S. veterans. 2. No significant gender differences were found in the associations between PTSD symptoms and pain outcomes.  Evidence Rating Level: 2 (Good)  Post-traumatic stress disorder (PTSD) and chronic pain are highly prevalent comorbid conditions in both veterans and civilians. Patients dually burdened by both PTSD and chronic pain experience more severe psychiatric impairments and incur a greater cost to the healthcare system...

1. Neutral version and 30° retroversion humeral components in reverse total shoulder arthroplasty had no significant difference in range of motion, muscle strength, or patient-reported outcomes.  Evidence Rating Level: 1 (Excellent)   Reverse total shoulder arthroplasty (rTSA) for patients with rotator cuff tear arthropathy improves forward elevation, pain, and function but can result in limited internal and external rotation. The goal of this randomized control trial was to determine if internal and external rotation are affected by the positioning of the humeral component (neutral or 30° of retroversion)...

1. Female infants had a greater association between experiences of early-life pain and altered neural connectivity as observed via magnetic resonance imaging.  2. Worse neurodevelopmental outcomes were associated with decreased brain connections.  Evidence Rating Level: 1 (Excellent) Study Rundown: Premature neonates are often subject to various lifesaving procedures. While receiving this care, they experience a period of rapid brain maturation, which may be vulnerable to environmental factors such as pain...

1. In this randomized controlled trial, there was no difference in the median time to sustained alleviation of coronavirus disease 2019 (COVID-19) symptoms between participants who received nirmatrelvir versus placebo. 2. The incidence of adverse events was similar in the nirmatrelvir and placebo groups, with dysgeusia being the most common event associated with nirmatrelvir. Evidence Rating Level: 1 (Excellent) Study Rundown: COVID-19, an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a threat to global health, with severe cases contributing to significant morbidity and mortality...

1. In post-stroke patients, endovascular thrombectomy (EVT) was associated with favourable outcomes on 5 separate cognitive tests that showed benefits to global cognitive function.  Evidence Rating Level: 2 (Good)  Endovascular thrombectomy (EVT) is a highly effective treatment for large vessel occlusion strokes that can improve functional neurologic outcomes. While EVT reduces infarct volume, cognitive outcomes have not been well-studied. To validate the quality of EVT therapy, patients were randomized to be treated either with the standard medical therapy or with standard medical therapy and EVT...

1. In this randomized controlled trial, l ixisenatide reduced motor disability progression in Parkinson’s patients . 2. Individuals in the lixisenatide group experienced greater gastrointestinal side effects rates than individuals in the placebo group. Evidence Rating Level: 1 (Excellent) Study Rundown: Dopaminergic replacement therapy has been used as the main treatment for Parkinson’s disease. However, it has been found to treat only the symptoms, not the progression. Some studies have shown an association between Parkinson’s disease and type 2 diabetes...

1. For diabetic patients undergoing hemodialysis, receiving foot and ankle care from a podiatrist within 3 months of a new diabetic foot ulcer diagnosis was associated with a reduced risk of major amputation and death. Evidence Rating Leve l: 2 (Good) Study Rundown: Diabetic foot ulcers (DFUs) are a significant complication of diabetes, contributing to 80% of lower extremity amputations, as well as diminished quality of life and greater mortality risk. About 10-32% of patients undergoing hemodialysis also suffer from active DFUs...

1. In this retrospective study, the chest X-ray cardiovascular disease (CXR CVD)-risk model performed similarly to the standard atherosclerotic (AS) CVD risk score at predicting 10-year risk for major adverse cardiovascular events (MACE). 2. Among patients with an unknown ASCVD risk score, those deemed statin-eligible by the model were nearly twice as likely to have incident MACE. Evidence Rating Level: 2 (Good) Study Rundown: Current guidelines recommend using a regression model based on nine variables to estimate a person’s 10-year risk for developing ASCVD...

1. In patients undergoing peritoneal dialysis, osteoporosis is highly prevalent but does not correlate to 25-vitamin D levels. Evidence Rating Level: 3 (Average)  One complication in patients with chronic kidney disease (CKD is increased bone turnover and decreased bone density. Bone mineral density (BMD) indicates bone mass and mineralization. It is determined using a Dual-Energy X-ray Absorptiometry (DEXA) scan at both the posteroanterior lumber spine (L1-L4) and the hip (femoral neck or total proximal femur)...

1. Serum neurofilament light chain (sNfL) elevations are a relatively specific biomarker of magnetic resonance imaging (MRI) disease activity in multiple sclerosis (MS) (82%–91.9% specificity) but have a low sensitivity (27.9%–42.6% sensitive) 2. Peak increase in sNfL was observed at an average of 9 weeks after the first Gd+ lesion was seen and remained high after resolution of Gd+ lesions in many participants.  Evidence Rating Level: 1 (Excellent)  Magnetic resonance imaging (MRIs) have been validated and included in the international guidelines for use as a prognostic marker in multiple sclerosis (MS)...

1. In this dose-escalation study, using intrathecal gene transfer with scAAV9/JeT-GAN demonstrated potential improvement in motor function. 2. Adverse events related to gene therapy included scoliosis, urinary tract infections, and upper respiratory tract infections. Evidence Rating Level: 2 (Good) Study Rundown: Giant axonal neuropathy is an autosomal recessive neurodegenerative disorder that results from loss of function mutations in the gene that codes for gigaxonin ( GAN ). Gigaxonin regulates the turnover of intermediate filaments, thus when it is absent, there is an accumulation of intermediate filaments leading to abnormal axonal swellings...

1. In this retrospective cohort study, exposure to antiseizure medications was associated with a higher incidence of autism spectrum disorder (ASD) compared to general population data. 2. Restricted to children born to mothers with epilepsy, valproate, but not topiramate and lamotrigine, was associated with an increased risk of ASD compared to no medication exposure. Evidence Rating Level: 2 (Good) Study Rundown: Most female adults with epilepsy receive antiseizure medications throughout pregnancy. Prenatal exposure to valproate is associated with neurodevelopmental disorders such as ASD and attention deficit hyperactivity disorder...

1. Clinically relevant bleeding was significantly lower with ticagrelor monotherapy than in the ticagrelor plus aspirin group. 2. Major cardiovascular and cerebrovascular events were comparable in both groups. Evidence Rating Level: 1 (Excellent) Study Rundown: Dual antiplatelet therapy (DAPT) is the current standard of care for acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI). However, data on single antiplatelet therapy with a potent P2Y12 inhibitor is lacking. This randomized trial aimed to assess whether ticagrelor alone, versus ticagrelor plus aspirin, reduces bleeding without increasing major adverse cardiovascular or cerebrovascular events (MACCE)...

1. Target-vessel failure was significantly lower in the ultrasound-guided group than the angiography-guided group. 2. There was no significant difference between groups concerning stent thrombosis. Evidence Rating Level: 1 (Excellent) Study Rundown: Angiography-guided percutaneous coronary intervention (PCI) is the current standard of care for patients with coronary artery stenosis, although this is associated with complications. Intravascular ultrasound (IVUS) has shown advantages over angiography in coronary interventions, but its benefits and safety profile for acute coronary syndrome (ACS) patients remain unclear...

1. The 18-month event-free survival in the perioperative nivolumab group was 70.2% vs 50.0% in the chemotherapy group with HR 0.58 (significant). 2. Grade 3-4 treatment-related adverse events occurred in 32.5% in the nivolumab group vs 25.2% in the chemotherapy group. Evidence Rating Level : 1 (Excellent) Study Rundown: Nivolumab, an anti-PD-1 antibody, combined with chemotherapy, has been used as neoadjuvant treatment for resectable non-small-cell lung cancer (NSCLC). Recently perioperative approaches, involving both neoadjuvant and adjuvant immunotherapy, have shown promising results in reducing disease relapse and improving overall survival...

1. I n this observational study, inpatients treated by a female physician had lower 30-day mortality rates, with female patients benefitting more than male patients. 2. Readmission rates were lower in patients treated by a female physician.  Evidence Rating Level: 2 (Good) Study Rundown: Healthcare quality may vary depending on provider and patient sociodemographic factors. It is important to understand the role that differing physician sex has in the care of patients and the disparities they face. To address the gap in prior literature, this study assessed the association between physician sex and important patient outcomes such as mortality and hospital admissions...

1. A decision support system using the Molecular International Prognostic Scoring System (IPSS-M) can optimize the timing of HSCT for MDS patients. 2. Patients with low and moderate-low risk MDS benefit from delayed HSCT, while those with higher risks benefit from immediate HSCT under the IPSS-M model. Evidence Rating Level: 2 (Good) Study Rundown: The present study conducted a retrospective analysis to develop a decision support system (DSS) for predicting the optimal timing for hematopoietic stem cell transplantation (HSCT) in patients with myelodysplastic syndromes (MDS), using clinical and genomic data from the IPSS-M score...

1. Consumption of ultra-processed foods was associated with modestly higher all cause mortality, with meat/poultry/seafood based ready-to-eat products showing the strongest associations. 2. No association between consumption of ultra-high processed foods and mortality from cancer, cardiovascular disease and respiratory diseases was found. Evidence Rating Level: 2 (Good) Ultra-high processed foods are products made from substances extracted from whole foods. These products often have very low nutritional value and may even contain harmful substances in the form of additives and contaminants...

1. At 12 months, patients with anterior cruciate ligament reconstruction randomized to receive postoperative intra-articular platelet-rich plasma injection were not found to have improved knee function compared to no postoperative injection. Evidence Rating Level: 1 (Excellent) Platelet-rich plasma (PRP), a product derived from autologous blood and rich in growth factors, has been viewed as a promising therapeutic option for various musculoskeletal disorders. However, there has been conflicting evidence for the efficacy of PRP use in patients undergoing anterior cruciate ligament reconstruction (ACLR), with recent studies showing that intraoperative injection was not associated with long term improvements...