One-Minute Telegram

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.

• 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

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.
• 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. ^[1]
• 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
    • Obtain dual-energy x-ray absorptiometry.
    • In addition, consider using a fracture risk assessment tool (e.g., FRAX, Fracture Risk Calculator).
  • 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.
• Study funding: Agency for Healthcare Research and Quality
• Original study: Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. ^[2]
• 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)
• 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:
  • Results are not generalizable to all high-risk groups.
  • Genotyping was not used to establish whether new cases of TB were contracted from the household contact or another source.
  • Other factors that could influence treatment efficacy (e.g., geographical setting) were not considered.
• 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. ^[3]
• Related AMBOSS articles: Tuberculosis

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:
    • SF-36-PFS score 12 months after enrollment (T2)
    • Symptom scores (e.g., for cognitive difficulties, anxiety and depression, bodily pain, and smell and taste abnormalities)
  • 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.
• 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. ^[4]
• 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.
• 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. ^[5]
• 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
    • All inpatient and outpatient hospital contacts for diagnoses of diabetes, liver disease, and heart disease
    • Death
• 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. ^[6]
• Related AMBOSS articles: Hemochromatosis