Introduction
The One-Minute Telegram is a biweekly digest of the latest medical research. It is designed for our colleagues who want to keep up with medical literature without having to comb through a flood of new research. Every paper has been carefully selected and summarized by our team of physician editors to bring you the most important developments as concisely as possible. Integration of AMBOSS tooltips and links to related content ensures you have all the context you need at your fingertips. Whether you're on your way home from a long shift or just taking a break on a busy day, you'll always find a minute to stay current. Subscribe by clicking on the image or via the link in “Tips and Links” below.
See also the One-Minute Telegram Archive 2024, One-Minute Telegram Archive 2023, One-Minute Telegram Archive 2022, One-Minute Telegram Archive 2021, and One-Minute Telegram Archive 2020.
Q1 2025
-
One-Minute Telegram 117-2025
- Expanding options for medication abortion
- Avian influenza: rising cases (and egg prices) but no evidence of human-to-human transmission
- Liraglutide: weight-loss drugs for children?
-
One-Minute Telegram 116-2025
- Valentine's day edition
- Sepsis immunotherapy: thymosin α1 falls short, but could some still benefit?
- ADHD linked to shorter life expectancy
-
One-Minute Telegram 115-2025
- Morning coffee: think fast, live long!
- Bone up on the updated USPSTF recommendations for osteoporosis screening to prevent fragility fractures
- Sharing isn’t always caring: preventing TB transmission with levofloxacin
-
One-Minute Telegram 114-2025
- Cognitive behavioral therapy for long COVID: a small but meaningful step?
- Less frequent breast cancer screening does not correlate with higher breast cancer stage at diagnosis
- Hemochromatosis comorbidities: iron overload may not be the only link
Edition 117 - March 1, 2025
Expanding options for medication abortion
One-Minute Telegram 117-2025-1/3
10-second takeaway
Induced abortion using a combination of mifepristone and misoprostol is safe and highly effective up to 77 days’ gestation; however, in many regions, mifepristone is expensive and availability is limited. In this two-stage clinical study, a medication abortion regimen combining the emergency contraceptive ulipristal acetate with misoprostol was shown to be effective and deemed acceptable to study participants. Larger, randomized studies are needed to confirm these findings and further elucidate the role of ulipristal in medication abortion.
Study breakdown
- Study population: adults (≥ 18 years) with an intrauterine pregnancy seeking abortion before 64 days’ gestation and a BMI ≤ 32 kg/m2
-
Study design: two-stage proof-of-concept study
- Stage 1: preparatory dose-finding study
- Randomized, open-label trial
- 66 participants were randomized 1:1 to 60 mg or 90 mg ulipristal, followed by 800 mcg misoprostol.
- Both doses of ulipristal had comparable safety and efficacy profiles.
- Stage 2: single-arm trial
- Intervention: An additional 100 participants received 60 mg ulipristal PO once, followed by 800 mcg misoprostol PO 24 hours later, and pain management with 400 mg ibuprofen PO as needed.
- Primary outcome: complete abortion without the need for additional management (i.e., expectant management, additional medication, or uterine evacuation) in the 133 participants who received 60 mg ulipristal across stages 1 and 2
- Secondary outcomes
- Participant satisfaction
- Pain score
- Post-treatment follow-up: 7–10 days
- Pelvic ultrasound to assess pregnancy status
- Structured questionnaire to assess acceptability
- Setting: outpatient reproductive health clinic in Mexico City
- Stage 1: preparatory dose-finding study
-
Main results
- Primary outcome
- Complete abortion at follow-up: 129/133 participants (97%; 95% CI, 94.1–99.9%)
- 4 participants required additional management at follow-up: 3 (2.3%) with ongoing pregnancy and 1 (0.8%) with incomplete abortion and bleeding.
- 3 participants experienced adverse events, but none were serious.
- Acceptability outcomes
- Satisfaction: 130/133 participants (97.7%; 95% CI, 95.2–100%) were satisfied or very satisfied; no participants were unsatisfied.
- Pain acceptability
- Primary outcome
-
Limitations include:
- The small sample size limits the ability to assess safety.
- Stage 2 was originally planned as a noninferiority trial with historical controls who received misoprostol monotherapy. The trial was not conducted, preventing direct efficacy comparisons.
- The study population was drawn from one health center in one geographic area, limiting generalizability.
- Study funding: OPTions Initiative
- Original study: A proof-of-concept study of ulipristal acetate for early medication abortion [1]
- Related AMBOSS articles: Induced abortion
Avian influenza: rising cases (and egg prices) but no evidence of human-to-human transmission
One-Minute Telegram 117-2025-2/3
10-second takeaway
Avian influenza A(H5N1) has been causing widespread infection in US poultry and cows; before 2024, only 1 human case had been identified in the US. This case series describes the 46 human cases of H5N1 identified in the US since March 2024. Almost all patients were exposed to infected poultry or cows, and no human-to-human transmission was confirmed. The illness was mild (the most common symptom was conjunctivitis), and detection rates were highest with conjunctival swabs. Providers should consider collecting conjunctival specimens in addition to respiratory specimens to more accurately identify patients with H5N1 infection.
Study breakdown
- Study population: 46 individuals with laboratory-confirmed influenza A(H5N1) infection
-
Study design: descriptive case series
- Setting: routine influenza surveillance conducted by state and local public health departments between March and October 2024
- Case identification
- Individuals with occupational exposure to animals with known or suspected H5N1 infection were monitored for symptoms for 10 days after exposure.
- Routine surveillance for novel influenza A
- Outcomes
- Case characteristics were collected using standardized case report forms.
- Specimens were sent to the CDC for testing using real-time RT-PCR and genetic sequencing for H5N1.
-
Main results
- 46 patients with H5N1 infection were identified.
- 25 patients were exposed to infected cows.
- 20 were exposed to infected poultry.
- 1 had no known exposure.
- Disease course
- Illness was mild: No patients became critically ill or died, but no patients were asymptomatic.
- Conjunctivitis was the most common symptom (93%), followed by fever (49%) and respiratory symptoms (36%).
- Median duration: 4 days
- Diagnostics
- Overall, detection rates were highest with conjunctival swabs (88%), followed by combined nasal-oropharyngeal swabs (41%) and nasopharyngeal swabs (33%).
- Patients with conjunctivitis: Conjunctival swabs were positive in 90% of samples.
- Patients with respiratory symptoms: Nasopharyngeal swabs were positive in 45% of samples, and combined nasal-oropharyngeal swabs were positive in 56%.
- Management: Most patients (87%) received oseltamivir, starting at a median of 2 days after symptom onset.
- No household contacts of patients with animal exposure had H5N1 infection.
- 46 patients with H5N1 infection were identified.
-
Limitations include:
- Monitoring varies between farms, and cases may be underreported or missed.
- Some data was missing from case report forms, and some case reports were collected before symptom resolution.
- It was not possible to identify specific behaviors that increase the risk of infection.
- Study funding: Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases cooperative agreement of the CDC (grant CK19-1904)
- Original study: Highly pathogenic avian influenza A(H5N1) virus infections in humans [2]
- Related AMBOSS content: Zoonotic influenza
Liraglutide: weight-loss drugs for children?
One-Minute Telegram 117-2025-3/3
10-second takeaway
Liraglutide is FDA-approved for the treatment of obesity in children ≥ 12 years of age, but its safety and efficacy in younger children is unknown. This pharmaceutical industry-sponsored randomized, placebo-controlled trial showed that in children aged 6–11 years, liraglutide combined with lifestyle modifications was more effective for weight loss than placebo combined with lifestyle modifications. However, just like adults, children regained weight after liraglutide was stopped. While liraglutide may become part of the toolkit for childhood obesity, it’s unclear whether it’s a game-changer or just a short-term solution.
Study breakdown
- Study population: 82 children (aged 6–11 years) with obesity
-
Study design: randomized, double-blind phase 3 placebo-controlled trial
- Setting: 23 clinical trial sites in 9 countries
- Intervention: liraglutide 3 mg subcutaneously once daily or placebo, plus lifestyle modifications for 56 weeks
- Primary endpoint: percentage change in BMI from baseline to week 56
- Safety endpoints: rates of adverse events and serious adverse events
- Post-treatment follow-up: 26 weeks
-
Main results
- Primary endpoint: BMI decreased 5.8% in the liraglutide group and increased 1.6% in the placebo group (mean difference, -7.4%; 95% CI, -11.6 to -3.2%).
-
≥ 5% reduction in BMI was seen in:
- 46% in the liraglutide group
- 9% in the placebo group (adjusted OR, 6.3; 1.4 to 28.8)
- At the end of the post-treatment follow-up period (week 82), both groups had gained weight; mean change in BMI from baseline was:
- -0.8% in the liraglutide group
- 6.7% in the placebo group
- Rates of adverse events and serious adverse events were similar in the two groups; gastrointestinal disorders were the most common adverse events.
-
Limitations include:
- There is a lack of consensus on meaningful weight loss in children.
- Most participants (70%) were White, limiting the generalizability of the results.
- Long-term safety and efficacy studies are needed.
- Study funding: Novo Nordisk
- Original study: Liraglutide for children 6 to <12 years of age with obesity — a randomized trial [3]
Edition 116 - February 15, 2025
Valentine’s Day edition
One-Minute Telegram 116-2025-1/3
- Love bytes: the sweet and strange world of AI relationships. Valentine’s Day may be over, but romance is still very much AI-live. A study of over 35,000 AI chatbot users revealed that people are forming emotional connections with their digital friends (or more than friends). From heartfelt chats to playful role-play, these AI BFFs bring joy, love, and laughter. But it’s not all sunshine and rainbows. While users love to morph chatbots into ideal companions, virtual intimacy can take an unsettling turn when feelings bounce back across the uncanny valley and you realize you’ve fallen for beautifully scripted code.
So, whether you spent February 14th with your soulmate, solo, or swapping Valentine’s wishes with a bot, one thing is clear: AI is staking its claim as the low-maintenance date of the future. Too bad it can’t pick up the check...
Original study
Finding love in algorithms: deciphering the emotional contexts of close encounters with AI chatbots [4]
Sepsis immunotherapy: thymosin α1 falls short, but could some still benefit?
One-Minute Telegram 116-2025-2/3
10-second takeaway
Adjunctive immunomodulatory therapy is a promising candidate for improving sepsis outcomes by targeting immune dysregulation and immunosuppression. Previous small studies have suggested that the immunomodulator thymosin α1 may reduce mortality in patients with sepsis. However, in this large double-blind, placebo-controlled randomized clinical trial of sepsis in China, treatment with thymosin α1 did not reduce 28-day all-cause mortality compared to placebo, although potential differential effects were noted in older adults and patients with diabetes. Studies targeting selected patient groups may better elucidate the role of immunomodulatory therapy in sepsis.
Study breakdown
- Study population: 1106 adults aged 18–85 years (median age, 65 years; 69% male) diagnosed with sepsis according to the Sepsis-3 criteria
-
Study design: multicenter, double-blind, placebo-controlled phase 3 trial
- Setting: 22 medical centers in China between September 2016 and December 2020
- Intervention: subcutaneous injection of 1.6 mg thymosin α1 or placebo every 12 hours for 7 days (in addition to standard treatment)
- Primary outcome: 28-day all-cause mortality (modified intention-to-treat analysis)
- Secondary outcomes included:
- 90-day all-cause mortality
- Changes in sequential organ failure assessment score on day 7
- Mechanical ventilation-free days within 28 days
- Continuous renal replacement therapy-free days within 28 days
- Vasopressor-free days within 28 days
- Follow-up: 90 days
-
Main results
- No overall effect on the primary outcome, which occurred in 127 participants (23.4%) in the thymosin α1 group and 132 (24.1%) in the placebo group (HR, 0.99; 95% Cl, 0.77–1.27)
- In subgroup analyses, there was a potential differential effect.
- Thymosin α1 appeared protective in individuals with diabetes (HR, 0.58; 0.35–0.99) but had no significant effect in those without diabetes (HR, 1.16; 0.87–1.53): P for interaction = 0.04.
- Thymosin α1 showed a potentially harmful effect in individuals aged < 60 years (HR, 1.67; 1.04–2.67) but not in those aged ≥ 60 years (HR, 0.81; 0.61–1.09): P for interaction = 0.01. However, in a post hoc analysis, no harmful effect was seen after adjusting for organ support before randomization.
- Secondary and safety outcomes: no significant differences between groups
-
Limitations include:
- Observed mortality rates (∼ 24%) were lower than hypothesized (35%), suggesting sicker patients with greater immune dysregulation were underrepresented.
- The study may have been underpowered based on the projected difference of 8% between the intervention and placebo groups.
- Timing from sepsis onset to randomization was uncertain. Most patients had multiple immune marker abnormalities at randomization, suggesting that treatment may not have been initiated early enough.
- Study funding: the Sun Yat-sen University Clinical Research Program 5010, Guangdong Clinical Research Center for Critical Care Medicine, and SciClone Pharmaceuticals
- Original study: The efficacy and safety of thymosin α1 for sepsis (TESTS): multicentre, double blinded, randomised, placebo controlled, phase 3 trial [5]
- Related AMBOSS articles: Sepsis
ADHD linked to shorter life expectancy
One-Minute Telegram 116-2025-3/3
10-second takeaway
Attention deficit hyperactivity disorder (ADHD) has been linked to poor health outcomes and an increased risk of premature death, but data on life expectancy deficits in individuals with ADHD is lacking. In this cohort study, mortality data from a national UK database showed that individuals diagnosed with ADHD had a significantly shorter life expectancy than matched controls. Further studies are needed to identify modifiable risk factors for premature death in this population.
Study breakdown
-
Study population: identified from 9,561,450 people in 792 general care practices
- Exposed group: 30,039 adults aged ≥ 18 years diagnosed with ADHD (21.82% female; median age at cohort entry, 18.95 years for male individuals and 22.10 years for female individuals)
- Comparison group: 300,390 adults matched by age, sex, and primary care practice
-
Study design: matched retrospective cohort study
- Setting: UK electronic primary care health records from IQVIA Medical Research Data from 2000 to 2019
- Exposure: ADHD diagnosis
- Outcome: all-cause death
- Data on baseline comorbidities and variables included:
- Socioeconomic deprivation
- Physical health conditions (e.g., diabetes, hypertension)
- Mental health conditions (e.g., anxiety, depression)
- Neurodevelopmental conditions (e.g., autism, intellectual disability)
- Substance use (e.g., tobacco, alcohol)
-
Main results
-
Mortality rates were higher in adults with ADHD than in controls.
- Male individuals: 0.83% vs. 0.52%
- Female individuals: 2.22% vs. 1.35%
-
ADHD was associated with a significant reduction in apparent life expectancy compared to controls.
- Male individuals: -6.78 years (95% CI, -9.11 to -4.50)
- Female individuals: -8.64 years (-10.91 to -6.55)
- Rates of all baseline comorbidities and variables were higher in adults with ADHD than in controls.
-
Mortality rates were higher in adults with ADHD than in controls.
-
Limitations include:
- The ADHD group may not have accurately represented all adults with ADHD, as it is estimated that only 1 in 9 adults with ADHD are diagnosed.
- Individuals with comorbidities may have been overrepresented in the ADHD group, as more health care contacts may have increased ADHD diagnosis rates, potentially leading to an overestimation of mortality in this group.
- Years of life lost could not be attributed to specific causes, as data on cause of death was not available.
- Race, ethnicity, and gender diversity were not accounted for and may have led to confounding.
- Study funding: Dunhill Medical Trust
- Original study: Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: matched cohort study. [6]
- Related AMBOSS articles: Attention deficit hyperactivity disorder
Edition 115 - February 1, 2025
Morning coffee: think fast, live long!
One-Minute Telegram 115-2025-1/3
10-second takeaway
Coffee, the world’s most popular psychoactive stimulant, lowers the risk of diabetes, cardiovascular disease (CVD), and death, but does the time of consumption matter? In this observational study, drinking coffee only in the morning was associated with decreased all-cause mortality and CVD-specific mortality compared to coffee abstinence. There was no difference in mortality between those drinking coffee all day and those abstaining from coffee. Coffee consumption late in the day may interfere with the body’s natural circadian rhythms, reducing coffee’s anti-inflammatory effects, but more research is needed to demonstrate this causality.
“Without my morning coffee, I’m just like a dried-up piece of roast goat.” - Johann Sebastian Bach
Study breakdown
- Study population: 40,725 US adults participating in the National Health and Nutrition Examination Survey from 1999 to 2018
-
Study design: observational cohort study
- Timing of coffee consumption was determined using self-reported dietary recall.
- Clustering analysis was used to identify coffee drinking patterns (for caffeinated and decaffeinated coffee).
- Non-coffee drinkers
- Morning type: consumption from 4 a.m. to 11:59 a.m.
- All-day type: consumption throughout the day
- Death and death rate information were obtained from the National Death Index until the end of 2019.
- Outcomes
- All-cause mortality
- CVD-specific mortality
- Cancer-specific mortality
-
Main results
-
All-cause mortality
- The morning-type group had a lower risk of all-cause mortality than non-coffee drinkers (HR, 0.88; 95% CI, 0.81–0.96).
- All-cause mortality was lowest in those who consumed 2–3 cups of coffee per day in the morning (HR, 0.71; 0.60–0.86).
- The risk of all-cause mortality was similar in the all-day-type group and non-coffee drinkers (HR, 0.99; 0.9–1.10).
- Cause-specific mortality
- The morning-type group had a lower risk of CVD-specific mortality than non-coffee drinkers (HR, 0.69; 0.55–0.87) but similar rates of cancer-specific mortality (HR, 0.97; 0.75–1.25).
- The risk of CVD-specific and cancer-specific mortality was similar in the all-day-type group and non-coffee drinkers.
- Similar associations were observed for caffeinated and decaffeinated coffee drinking.
-
All-cause mortality
-
Limitations include:
- Results were based on self-reporting, which is subject to recall bias.
- Morning-type coffee consumption may be a marker of unmeasured confounding variables (e.g., regular work hours, healthy lifestyle).
- Study funding: The National Heart, Lung, and Blood Institute; National Institute of Diabetes and Digestive and Kidney Disease; and National Institute of Health
- Original study: Coffee drinking timing and mortality in US adults. [7]
- Related AMBOSS articles: Stimulant intoxication and withdrawal
Bone up on the updated USPSTF recommendations for osteoporosis screening to prevent fragility fractures
One-Minute Telegram 115-2025-2/3
10-second takeaway
Osteoporosis occurs in over 25% of women in the US aged 65 years and older and is associated with an increased risk of fragility fractures, often accompanied by secondary complications. The US Preventive Services Task Force (USPSTF) recommends osteoporosis screening for all women 65 years of age and older and for younger postmenopausal women with one or more risk factors for osteoporosis to prevent fragility fractures. There are no recommendations for screening for osteoporosis in men. In a separate statement, the USPSTF also provides recommendations for the prevention of falls in older adults to further reduce the risk of fragility fractures.
Recommendations breakdown
-
Recommendations
- Screen all women 65 years of age and older for osteoporosis.
- Screen postmenopausal women younger than 65 years of age if they have one or more risk factors for osteoporosis.
- Applicable population: adults ≥ 40 years of age without known osteoporosis, history of a fragility fracture, or risk factors for secondary osteoporosis (e.g., chronic glucocorticoid use)
- Rationale: The USPSTF concluded with moderate certainty that screening for osteoporosis to prevent osteoporotic fractures has moderate net benefit.
-
Implementation
- Women ≥ 65 years of age
-
Postmenopausal women < 65 years of age
- Assess for risk factors for osteoporosis.
- If ≥ 1 risk factors are present, use a risk assessment tool (e.g., Osteoporosis Risk
- Assessment Instrument, FRAX).
- If risk is increased, follow the screening protocol for women ≥ 65 years of age.
-
Additional information
-
Risk factors for osteoporosis in this recommendation are:
- Low BMI
- Parental history of hip fracture
- Excess alcohol consumption
- Current cigarette smoking
- Current evidence is insufficient to assess the benefits and harms of osteoporosis screening in men.
-
Risk factors for osteoporosis in this recommendation are:
- Study funding: Agency for Healthcare Research and Quality
- Original study: Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. [8]
- Related AMBOSS articles: Osteoporosis
Sharing isn’t always caring: preventing TB transmission with levofloxacin
One-Minute Telegram 115-2025-3/3
10-second takeaway
Every year, half a million people develop multidrug-resistant tuberculosis (MDR-TB), but little is known about how to prevent transmission to close contacts. In this meta-analysis of two phase 3 trials, individuals taking daily levofloxacin had a 60% lower risk of contracting TB from a household contact with MDR-TB than those taking a placebo. Low-grade musculoskeletal events more frequently occurred in the levofloxacin group than in the placebo group; there was no association between levofloxacin and severe adverse events (AEs). Further research is needed to determine the optimal duration and cost-effectiveness of levofloxacin prophylaxis.
Study breakdown
- Study population: 2963 individuals with household exposure to MDR-TB or rifampin-resistant TB and evidence of latent Mycobacterium tuberculosis (Mtb) infection, HIV infection, or (in the Vietnam study only) severe malnutrition
-
Study design: combined analysis of two randomized placebo-controlled phase 3 trials
- Study 1: Vietnam Quinolones for MDR-TB (VQUIN)
- Primarily included adults in Vietnam
- 2041 participants (median age, 40 years)
- Study 2: Tuberculosis Child Multidrug-resistant Preventive Therapy (TB-CHAMP)
- Children in South Africa
- Initially limited to children < 5 years of age but later expanded to children ≤ 17 years of age
- 922 participants (median age, 2.8 years)
- Study 1: Vietnam Quinolones for MDR-TB (VQUIN)
-
Main results
- Incidence of TB at 54 weeks was lower in the levofloxacin group than in the placebo group (relative difference in cumulative incidence, 0.41; 95% CI, 0.18–0.92).
-
NNT to prevent one case of TB at 54 weeks
- VQUIN: 193 (95% CI, 98–5158)
- TB-CHAMP: 56 (30–466)
- The incidence of severe AEs was similar in the levofloxacin and placebo groups (risk ratio, 1.07; 95% CI, 0.7–1.65).
- The risk of developing musculoskeletal AEs was significantly higher in the levofloxacin group than in the placebo group (risk ratio, 6.36; 4.3–9.42).
- 97% were nonsevere (grade 1 or 2) AEs.
- The association was not seen in children < 10 years of age.
- Limitations include:
- Study funding: UK Medical Research Council, Australian National Health and Medical Research Council, UNITAID, and others
- Original study: A meta-analysis of levofloxacin for contacts of multidrug-resistant tuberculosis. [9]
- Related AMBOSS articles: Tuberculosis
Edition 114 - January 18, 2025
Cognitive behavioral therapy for long COVID: a small but meaningful step?
One-Minute Telegram 114-2025-1/3
10-second takeaway
Post-COVID-19 condition (PCC) is an often debilitating complication of COVID-19 infection, but evidence-based management for PCC is limited. In this randomized clinical trial, patients with mild to moderate PCC participating in an outpatient rehabilitation program using a cognitive behavioral therapy (CBT) approach had significantly better physical functioning than those receiving usual care, with a small to moderate effect size. Clinicians may consider referral to outpatient CBT for certain patients with PCC depending on implementation feasibility and patient preference.
Study breakdown
- Study population: 314 individuals aged ≥ 16 years (mean age, 43 years; 72% female) with mild to moderate PCC
-
Study design: pragmatic randomized clinical trial
- Setting: single outpatient referral center clinic in Norway between February 2022 and April 2024
- Intervention: Participants were randomized 1:1 to either usual care or an outpatient rehabilitation program consisting of visits every 2–6 weeks (total 2–8 visits) based on a cognitive and behavioral approach.
- Primary outcome
- Change in 36-Item Short Form Health Survey Physical Function Subscale (SF-36-PFS) scores between enrollment (T0) and immediately after intervention completion (T1)
- Higher scores indicate better physical functioning.
- Secondary outcomes included:
- Safety outcomes included:
- Contact with primary health care services
- Hospital admissions
- Occurrence of new disease
- Follow-up: 12 months
-
Main results
- Primary outcome
- Improvement in SF-36-PFS at T1 was significantly greater in the intervention group vs. the usual care group (score difference, 9.2; 95% CI, 4.3–14.2).
- The effect size was small to moderate (Cohen’s d = 0.43).
- Secondary outcomes
- SF-36-PFS at T2 was sustained, favoring the intervention group.
- Except smell and taste abnormalities and bodily pain, all secondary outcome measures at T2 (and most at T1) favored the intervention group over the usual care group, with small to moderate effect sizes.
- Safety outcomes: Self-reported health statuses at T1 and T2 were better in the intervention group than in the usual care group for most items, except hospital admissions and new disease occurrence at T2.
- Primary outcome
-
Limitations include:
- Blinding was not possible, potentially leading to the placebo effect.
- Participants had only moderate impairment, and results may not be generalizable to patients with severe PCC.
- Study funding: Akershus University Hospital and others
- Original study: Brief outpatient rehabilitation program for post–COVID-19 condition: a randomized clinical trial. [10]
- Related AMBOSS articles: COVID-19
Less frequent breast cancer screening does not correlate with higher breast cancer stage at diagnosis
One-Minute Telegram 114-2025-2/3
10-second takeaway
In 2009, the USPSTF recommended increasing breast cancer screening intervals for women with an average risk. In this retrospective cohort study using US data from 2004 to 2019, the incidence of in situ breast cancer in women aged ≥ 40 years decreased since 2009, aligning with the reduced use of screening mammography after the guideline changes. However, there was no correlation between the change in recommendations and breast cancer stage at diagnosis or type of surgical treatment. Surgical trends shifted toward breast-conserving surgeries and reconstructive approaches over time. This result may reassure primary care physicians that the shift in recommendations has not resulted in a higher incidence of advanced breast cancer at diagnosis and may have reduced unnecessary interventions and anxiety caused by false-positive results.
Study breakdown
- Study population: 2,022,250 women aged ≥ 40 years with breast cancer (17.5% aged 40–49 years, 63.2% aged 50–74 years, and 19.2% aged ≥ 75 years)
-
Study design: population-based, epidemiological, retrospective cohort study
- Setting: Data was collected from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program in the US from 2004 to 2019.
- Outcomes according to age group (40–49 years, 50–74 years, and ≥ 75 years)
- Incidence rates of breast cancer by stage at diagnosis
- Patients treated with partial mastectomy, total mastectomy, and total mastectomy with reconstruction
-
Main results
- In situ breast cancer
- Rates increased until 2009 in women aged 40–49 years and until 2008 in women aged ≥ 50 years.
- This was followed by a decline across all age groups; rates stabilized after 2016 in women aged ≥ 75 years.
- Localized breast cancer
- Rates increased steadily from 2004 to 2019 in women aged 40–74 years.
- Rates in women aged ≥ 75 years rose from 2004 to 2011, declined from 2011 to 2017, and sharply increased from 2017 to 2019.
- Regional breast cancer
- Rates decreased until 2016 in women aged 40–49 years, until 2019 in women aged 50–74 years, and from 2008 to 2017 in women aged ≥ 75 years.
- Rates remained largely stable across all age groups thereafter.
- Distant breast cancer: Rates remained stable from 2012 for women aged 40–74 years, while the rates consistently increased for women aged ≥ 75 years between 2004 and 2019.
- Surgical therapy
- Partial mastectomy: Rates increased in women aged ≥ 75 years and after 2012 in women aged 50–74 years.
- Total mastectomy: Rates consistently declined in women aged 40–49 years and ≥ 75 years, and, after 2012, in women aged 50–74 years.
- Total mastectomy with reconstruction: Rates steadily rose in women aged 40–49 years throughout the study period and until 2012 in women aged 50–74 years.
- In situ breast cancer
-
Limitations include:
- The SEER registries do not capture the entire US population, limiting the generalizability of the findings.
- The risk of confounding by unmeasured factors (e.g., the introduction of digital breast tomosynthesis in 2011, which may have biased results by increasing early-stage cancer detection despite reduced screening) makes it difficult to isolate the true impact of the 2009 guideline changes.
- The study did not account for how breast cancers were detected (i.e., screening vs. symptom-based), which could influence the observed incidence rates and treatment patterns.
- The follow-up period after the guideline change was limited to 10 years, which may not have been sufficient time to capture certain trends.
- Study funding: National Institute of General Medical Sciences
- Original study: Changes to the US Preventive Services Task Force screening guidelines and incidence of breast cancer. [11]
- Related AMBOSS articles: Breast cancer
Hemochromatosis comorbidities: iron overload may not be the only link
One-Minute Telegram 114-2025-3/3
10-second takeaway
Previously, the increased risk of diabetes and other comorbidities (e.g., liver disease) in individuals with hereditary hemochromatosis was thought to be linked to iron overload. In this prospective cohort study, individuals homozygous for HFE C282Y had a higher risk of liver diseases and diabetes than non-carriers. Furthermore, the risk of diabetes was also higher in those with normal transferrin saturation and ferritin levels. Individuals homozygous for HFE C282Y with diabetes had a higher risk of death than non-carriers with diabetes. These findings highlight the need for clinicians to remain vigilant for diabetes and its complications in individuals with hereditary hemochromatosis, even in those with normal iron and ferritin levels and transferrin saturation.
Study breakdown
- Study population: 132,542 individuals aged 20–100 years, of which 422 individuals (median age, 56 years; 46% male) were homozygous for HFE C282Y
-
Study design: prospective cohort study
- Setting: 3 general population cohorts in Denmark
- Exposure
- HFE variants C282Y and H63D
- Plasma iron and ferritin levels and transferrin saturation (measured on the day of enrollment for most participants)
- Main outcomes
-
Main results
- Median follow-up: 41 years
- Compared to non-carriers, C282Y homozygotes:
- Had an increased risk for diabetes diagnosis (HR, 1.72; 95% CI, 1.24–2.39), diabetes with complications (2.03; 1.22–3.38), any liver disease (2.22; 1.40–3.54), and liver cirrhosis (3.42; 1.41–8.27)
- Had a higher risk of diabetes even if transferrin saturation and/or ferritin levels were normal
- Did not have a higher risk for heart disease diagnosis
- C282Y homozygotes with diabetes had a higher risk of death from any cause than non-carriers with diabetes (1.94; 1.19–3.18).
- Compared to non-carriers, the risk of diabetes or liver disease was not significantly higher in H63D homozygotes or heterozygotes, C282Y heterozygotes, or C282Y/H63D compound heterozygotes.
-
Limitations include:
- The study was unable to determine whether the increased mortality in C282Y homozygotes with diabetes was caused by diabetes or another unknown associated condition.
- Plasma iron and ferritin levels and transferrin saturation were only measured at study enrollment, meaning that iron overload before the onset of diabetes cannot be ruled out.
- The study was underpowered to analyze the risk of specific causes of death.
- Study funding: The Capital Region of Denmark, Independent Research Fund Denmark, Danish Heart Foundation, and Copenhagen University Hospital
- Original study: Mortality and risk of diabetes, liver disease, and heart disease in individuals with haemochromatosis HFE C282Y homozygosity and normal concentrations of iron, transferrin saturation, or ferritin: prospective cohort study. [12]
- Related AMBOSS articles: Hemochromatosis