KEY FINDINGS: Cognitive behavior therapy and interpersonal psychotherapy are the mainstay of treatment for peripartum depression; physicians should consider selective serotonin reuptake inhibitors for those with moderate to severe depression. The benefits of selective serotonin reuptake inhibitors generally outweigh the risks; however, fluoxetine and paroxetine should be avoided during pregnancy because they can cause an increased risk of birth defects.
BACKGROUND: Peripartum depression is one of the most common disorders of pregnancy. It has a higher morbidity and mortality risk than any other condition affecting pregnant people.
DETAILS: The American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the U.S. Preventive Services Task Force recommend that pregnant patients be screened for depression with one of several validated tools and offered treatment with psychotherapy and medication. There are no validated tools available to identify who is at increased risk of peripartum depression. Risk factors for peripartum depression include a history of depression, a history of physical or sexual abuse, carrying an unplanned or unwanted pregnancy, and traumatic birth. The U.S. Preventive Services Task Force recommends offering psychotherapy to patients at increased risk of depression because it can decrease the development of peripartum depression by up to 39%. Untreated peripartum depression increases the risk of adverse pregnancy outcomes and mortality for the patient, as well as negative outcomes for the newborn, including growth faltering, developmental delay, and attachment disorder.
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Source: Justesen, K. and Jourdaine, D. (2023). Peripartum Depression: Detection and Treatment. Am Fam Physician. 2023; 108(3): 267-272. Published: September, 2023.
KEY FINDINGS: In this phase II study, azacitidine, venetoclax, and gilteritinib produced high remission rates and encouraging long-term survival in patients with newly diagnosed FLT3-mutated AML who were unfit for intensive chemotherapy. The 3-year RFS and OS rates were 43% and 46%, respectively, although outcomes were less favorable in patients with FLT3-ITD mutations and baseline RAS pathway mutations. Most evaluable relapses were FLT3-negative, suggesting that resistance may involve mechanisms beyond persistent FLT3-mutated disease. Dose or duration reductions were frequently required during consolidation, primarily reflecting the challenge of managing myelosuppression. Randomized studies are needed to establish the role of this triplet regimen relative to current standard approaches.
BACKGROUND: Relapse after frontline azacitidine and venetoclax remains a major challenge in patients with FLT3-mutated acute myeloid leukemia (AML), with relapse often associated with expansion of FLT3-mutated clones. This phase II study evaluated the long-term efficacy and safety of adding the FLT3 inhibitor gilteritinib to azacitidine and venetoclax in adults with newly diagnosed FLT3-mutated AML who were considered unfit for intensive chemotherapy.
DETAILS: Thirty patients with newly diagnosed FLT3-mutated AML were treated with the azacitidine, venetoclax, and gilteritinib triplet regimen. The median age was 71 years, and 22 (73%) patients had FLT3-ITD mutations. Fourteen patients (47%) proceeded to allogeneic hematopoietic stem cell transplantation in first remission. The median follow-up was 41.5 months.
The complete remission or complete remission with incomplete hematologic recovery rate was 96%. Eleven patients (37%) subsequently relapsed, and among evaluable relapses, the FLT3 mutation was no longer detectable in 67%, indicating that relapse mechanisms were not necessarily driven by persistent FLT3-mutated disease.
The median relapse-free survival (RFS) was 23.4 months and median overall survival (OS) was 29.7 months. At 3 years, RFS was 43% and OS was 46%. Among patients with FLT3-ITD-mutated AML, median RFS and OS were 17.0 months and 21.8 months, respectively, with 3-year RFS and OS rates of 32% and 36%. Baseline RAS pathway mutations were associated with poorer outcomes.
Survival outcomes were similar regardless of whether patients underwent allogeneic hematopoietic stem cell transplantation in first remission. Among patients receiving at least one consolidation cycle, 68% required a reduction in the dose or duration of at least one study drug, highlighting the need to manage treatment-related myelosuppression during prolonged therapy.
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Source: Short, N. J., Kantarjian, H. M., Daver, N., et al. Long-Term Outcomes of Azacitidine, Venetoclax and Gilteritinib in Newly Diagnosed FLT3-Mutated AML. Blood Advances.. 2026; 10(17): 5743–5750. Published: May 27, 2026. DOI: 10.1182/bloodadvances.2026019841.
[Posted 2/Sep/2026]
AUDIENCE: Hematology, Oncology
KEY FINDINGS: In this phase II study, azacitidine, venetoclax, and gilteritinib produced high remission rates and encouraging long-term survival in patients with newly diagnosed FLT3-mutated AML who were unfit for intensive chemotherapy. The 3-year RFS and OS rates were 43% and 46%, respectively, although outcomes were less favorable in patients with FLT3-ITD mutations and baseline RAS pathway mutations. Most evaluable relapses were FLT3-negative, suggesting that resistance may involve mechanisms beyond persistent FLT3-mutated disease. Dose or duration reductions were frequently required during consolidation, primarily reflecting the challenge of managing myelosuppression. Randomized studies are needed to establish the role of this triplet regimen relative to current standard approaches.
BACKGROUND: Relapse after frontline azacitidine and venetoclax remains a major challenge in patients with FLT3-mutated acute myeloid leukemia (AML), with relapse often associated with expansion of FLT3-mutated clones. This phase II study evaluated the long-term efficacy and safety of adding the FLT3 inhibitor gilteritinib to azacitidine and venetoclax in adults with newly diagnosed FLT3-mutated AML who were considered unfit for intensive chemotherapy.
DETAILS: Thirty patients with newly diagnosed FLT3-mutated AML were treated with the azacitidine, venetoclax, and gilteritinib triplet regimen. The median age was 71 years, and 22 (73%) patients had FLT3-ITD mutations. Fourteen patients (47%) proceeded to allogeneic hematopoietic stem cell transplantation in first remission. The median follow-up was 41.5 months.
The complete remission or complete remission with incomplete hematologic recovery rate was 96%. Eleven patients (37%) subsequently relapsed, and among evaluable relapses, the FLT3 mutation was no longer detectable in 67%, indicating that relapse mechanisms were not necessarily driven by persistent FLT3-mutated disease.
The median relapse-free survival (RFS) was 23.4 months and median overall survival (OS) was 29.7 months. At 3 years, RFS was 43% and OS was 46%. Among patients with FLT3-ITD-mutated AML, median RFS and OS were 17.0 months and 21.8 months, respectively, with 3-year RFS and OS rates of 32% and 36%. Baseline RAS pathway mutations were associated with poorer outcomes.
Survival outcomes were similar regardless of whether patients underwent allogeneic hematopoietic stem cell transplantation in first remission. Among patients receiving at least one consolidation cycle, 68% required a reduction in the dose or duration of at least one study drug, highlighting the need to manage treatment-related myelosuppression during prolonged therapy.
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Source: Short, N. J., Kantarjian, H. M., Daver, N., et al. Long-Term Outcomes of Azacitidine, Venetoclax and Gilteritinib in Newly Diagnosed FLT3-Mutated AML. Blood Advances.. 2026; 10(17): 5743–5750. Published: May 27, 2026. DOI: 10.1182/bloodadvances.2026019841.
KEY FINDINGS: Approximately one in four women with recent GDM developed hypertension by 5 months postpartum. Higher maternal weight and blood pressure early in pregnancy, as well as Black or mixed ethnicity, were associated with increased risk, while gestational hypertension or pre-eclampsia was also associated with postpartum hypertension. Women with postpartum hypertension had greater adiposity and more frequent dyslipidemia, highlighting the broader cardiometabolic abnormalities present after GDM. Because early-pregnancy characteristics provided only modest prediction, the findings support structured postpartum assessment that includes blood pressure and broader cardiometabolic risk evaluation rather than focusing solely on dysglycemia.
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with an increased risk of later cardiometabolic disease, including hypertension. However, the occurrence and determinants of hypertension soon after pregnancy complicated by GDM have not been well defined. This prospective study evaluated the incidence and predictors of hypertension at 5 months postpartum and examined its relationship with other cardiometabolic abnormalities in women with recent GDM.
DETAILS: This single-center observational prospective cohort study was conducted at King's College Hospital, London, between September 2023 and January 2025. Women with GDM who received routine prenatal care at 12 weeks' gestation were invited for a postpartum assessment at approximately 5 months after delivery; women with chronic hypertension were excluded. The assessment included blood pressure, BMI, waist circumference, glucose status, lipid profile, and renal function. Hypertension was defined as systolic BP ≥ 130 mmHg, diastolic BP ≥ 80 mmHg, or receipt of antihypertensive treatment. Of 912 women with GDM invited for postpartum review, 696 (76.3%) attended. After excluding 18 women with chronic hypertension, 678 women constituted the study cohort. Follow-up occurred at a median of 5.1 (IQR, 4.4-6.7) months after birth.
Among the 678 women with previous GDM, 179 (26.4%) developed hypertension at a median of 5.1 (IQR, 4.4-6.7) months postpartum. Women who subsequently developed hypertension had higher early-pregnancy weight and blood pressure. At 12 weeks' gestation, median weight was 79.3 kg versus 69.3 kg among women who remained normotensive, while median systolic BP was 121.8 versus 115.5 mmHg and median diastolic BP was 74.5 versus 70.3 mmHg, respectively. Obesity at this stage was also more frequent among women who later developed hypertension (50.3% vs 28.5%). Pregnancy hypertensive disorders were more common among women who developed postpartum hypertension. Gestational hypertension occurred in 8.4% versus 3.8%, and pre-eclampsia in 9.5% versus 1.8%, among women who developed postpartum hypertension compared with those who remained normotensive.
Multivariable analysis identified higher maternal age, Black or mixed ethnicity, higher weight, and higher systolic and diastolic BP at 12 weeks as predictors of postpartum hypertension. Black ethnicity was associated with an adjusted OR of 1.88 (95% CI, 1.19-3.00), mixed ethnicity with an adjusted OR of 2.75 (95% CI, 1.21-6.24), and weight ≥ 73 kg with an adjusted OR of 1.57 (95% CI, 1.04-2.38). Each 1-mmHg increase in systolic BP was associated with an adjusted OR of 1.04 (95% CI, 1.02-1.07), and each 1-mmHg increase in diastolic BP with an adjusted OR of 1.04 (95% CI, 1.00-1.07). Development of gestational hypertension or pre-eclampsia was associated with an adjusted OR of 3.00 (95% CI, 1.69-5.34).
At the postpartum assessment, women with hypertension had a median BMI of 30.1 (IQR, 26.7-36.8) kg/m² compared with 27.0 (IQR, 23.5-30.6) kg/m² among normotensive women. A waist-to-height ratio > 0.5 was present in 87.7% versus 69.1%, and dyslipidemia in 35.8% versus 24.4%, respectively. Dysglycemia and renal dysfunction did not differ significantly between the groups.
The prenatal prediction model had only modest discriminatory ability. The AUC was 0.723 (95% CI, 0.680-0.766) using characteristics available at 12 weeks and 0.739 (95% CI, 0.697-0.782) after adding gestational hypertension or pre-eclampsia. At a 20% false-positive rate, detection rates were 49.5% and 53.7%, respectively.
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Source: Gomez Fernández, C., Charakida, M., Moser, M., et al. Hypertension at 5 months postpartum in women with gestational diabetes. Ultrasound in Obstetrics & Gynecology. 2026; 68(2): 202-210. Published: July 17, 2026. DOI: 10.1002/uog.70291.
KEY FINDINGS: Clinicians should consider Pso-Ec when an adult patient has persistent lesions showing simultaneous psoriasiform and eczematous clinical and histopathologic characteristics, particularly when there is no clear dominant inflammatory pathway. In this study, the phenotype was associated with dual Th2/Tc2 and Th17/Tc17 activity and involvement of JAK1-STAT2/6 signaling. Prior Pso- or AD-directed biologics were often inadequate, whereas JAK1 inhibitors achieved minimal disease activity with BSA ≤2 and NRS ≤1 during a median 17-month follow-up. The findings support recognition of Pso-Ec as a distinct phenotype and suggest JAK1 inhibition as a mechanism-based therapeutic approach. The study's interpretation is limited by its small sample size and the fact that immunologic analyses were performed in a representative subset of patients.
BACKGROUND: Psoriasis (Pso) and atopic dermatitis (AD) are generally characterized by different dominant inflammatory pathways. However, some patients present with lesions containing both psoriasiform and eczematous features, creating diagnostic and therapeutic challenges. This prospective study characterized a distinct psoriasis–atopic dermatitis overlapping phenotype, termed Pso-Ec, with particular attention to its clinical, histopathologic, immunologic, and treatment characteristics.
DETAILS: The two-center prospective study enrolled 30 patients with Pso-Ec between January 2021 and December 2025. Reference cohorts consisted of 150 patients with typical Pso and 150 with AD. The Pso-Ec group included patients aged 13-72 years, with a mean age of 49.7 ± 17.7 years and a male-to-female ratio of 19:11. None had a previous history of Pso or AD. Notably, 63.3% had associated atopic diseases, compared with 2.7% of patients with typical Pso and 47.3% of those with AD (P < .001). Pso-Ec lesions were characterized clinically by ill-defined erythematous plaques, thin scales, excoriation, and prominent pruritus. Histopathologic examination demonstrated concurrent psoriatic and eczematous features within the same lesions. Immunologic assessment of lesional skin and peripheral blood identified simultaneous type 2 and type 3 inflammatory activity, represented by Th2/Tc2 and Th17/Tc17 populations. JAK1-STAT2/6 signaling was also implicated in the inflammatory profile.
Treatment histories indicated that conventional pathway-directed biologic therapy was frequently inadequate in this phenotype. Among the Pso-Ec patients, 18 had previously received Pso-targeted biologics and 15 had received AD-targeted biologics, with responses described as often inadequate. In contrast, treatment with JAK1 inhibitors was associated with achievement of minimal disease activity, defined as body surface area (BSA) ≤2 and numerical rating scale (NRS) ≤1. This response was maintained during a median follow-up of 17 months. During follow-up, none of the patients progressed to a classic Pso or AD phenotype.
The investigators concluded that Pso-Ec represents a distinct, predominantly adult-onset inflammatory phenotype rather than simply a transitional presentation between psoriasis and atopic dermatitis. Its defining immunologic characteristic is the concurrent presence of type 2 and type 3 inflammation, which may explain the limited effectiveness of therapies directed primarily against either pathway. JAK1 inhibition emerged as an effective treatment option in this cohort.
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Source: Chen, M., Shen, C., Chen, C. B., et al. A Distinct Psoriasis–Atopic Dermatitis Overlapping Phenotype in Adults With Dual Type 2 and Type 3 Immune Features and Favorable Response to Janus Kinase 1 Inhibition. Journal of the American Academy of Dermatology. 2026; Published: September 22, 2026. DOI: 10.1016/j.jaad.2026.05.042.
KEY FINDINGS: Across five experimental studies, AI educational services were associated with greater guilt, lower perceived value, and, in several conditions, less willingness to recommend the approach compared with direct parental engagement. The findings indicate that reluctance to use AI for children's education may be linked less to perceptions of AI capability and more to the belief that educating one's children is a parental responsibility. The study also suggests that framing AI use as necessary because of an individual's limitations, or demonstrating that other parents use AI services, may improve positive WOM toward these services.
BACKGROUND: Artificial intelligence (AI) educational services are increasingly positioned as tools that can assist children with learning and tutoring. However, the decision to use these services may be influenced by more than their perceived educational capability. This research examined how choosing AI educational services rather than direct parental involvement affects guilt, perceived value, and willingness to recommend the approach to others. Across five experimental studies, the investigators also examined whether perceived parental responsibility, intrinsic reasons for using AI, and conformity influence these responses.
DETAILS: The research used experimental designs comparing parental engagement with AI educational services across homework and writing-tutoring scenarios. Study 1a included 191 participants after exclusion of 9 cases; Study 1b included 200 participants; Study 2 included 200 participants; Study 3 included 390 participants; and Study 4 included 400 participants. Participants were recruited through the Credamo online platform.
In Study 1a, participants who considered using AI educational services reported greater guilt and assigned a lower monetary valuation than those who personally tutored their children. Mean guilt scores were 2.74 (SD 1.81) with AI educational services versus 2.09 (SD 1.58) with parental engagement (t=2.67, p=.008). Mean valuation was 1219.31 (SD 1154.32) versus 2097.99 (SD 2217.96), respectively (t=3.41, p=.001).
Study 1b reproduced these findings without using pictures and after accounting for parental status. Guilt was higher with AI educational services than with parental engagement (5.23 [SD 2.94] vs 3.79 [SD 2.47]; F(1, 198)=14.07, p<.001, ηp2=.07). Valuation was lower with AI educational services (1219.62 [SD 1581.27] vs 2494.11 [SD 2530.90]; F(1, 198)=18.24, p=.001, ηp2=.08).
Study 2 extended the analysis to willingness to recommend the educational approach. Participants using AI educational services reported greater guilt, lower valuation, and lower word-of-mouth (WOM) intentions than participants engaging in education themselves. Among participants with children, guilt means were 3.09 (SD 2.35) for AI educational services and 2.32 (SD 2.31) for parental engagement (F=4.18, p=.043, ηp2=.03). Valuation was 477.83 (SD 547.20) versus 968.14 (SD 780.09), respectively (F=21.14, p<.001, ηp2=.12), while WOM was 7.83 (SD 1.65) versus 8.23 (SD 1.41) (F=4.77, p=.030, ηp2=.03).
Perceived responsibility for children's education emerged as an important explanatory mechanism. Attribution scores among participants with children were 6.27 (SD 2.50) in the AI condition and 8.79 (SD 0.86) in the parental-engagement condition (F=87.92, p<.001, ηp2=.36). Mediation analysis showed that attribution significantly mediated the relationship between educational approach and guilt, valuation, and WOM, with effects of 0.6116, -183.9280, and -0.8910, respectively.
Study 3 demonstrated that the reason for choosing AI could alter the pattern of WOM responses. When participants lacked the ability to tutor their children, those using AI educational services reported greater positive WOM than those personally tutoring their children: 7.60 (SD 1.47) versus 6.76 (SD 2.29), p=.006. In the control condition, the pattern was reversed, with WOM scores of 7.36 (SD 1.90) for AI educational services and 7.86 (SD 1.23) for parental engagement (p=.04).
Study 4 found that social conformity also influenced WOM. Overall, WOM was lower with AI educational services than with parental engagement: 7.59 (SD 2.19) versus 8.30 (SD 1.10) (F(1, 396)=17.23, p.001, ηp2=.04). When participants were given information that other parents were using AI educational services, the difference was no longer statistically significant (7.88 [SD 1.94] vs 8.24 [SD 1.23], p=.133). Without such conformity information, WOM was significantly lower for AI educational services (7.29 [SD 2.39] vs 8.36 [SD 0.94], p<.001).
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Source: Shao, A., Lu, Z., Liu, S. Q., et al. Demystifying the mist: Why do individuals hesitate to accept AI educational services?. British Journal of Psychology. 2026; 117(3): 932-956. Published: August, 2026. DOI: 10.1111/bjop.70040.
KEY FINDINGS: Among adults with cancer approaching death, hospice utilization was associated with less frequent and lower-intensity broad-spectrum antibiotic exposure, particularly during the final days of life. The findings are consistent with a transition toward comfort-focused care, although they do not establish that hospice care itself caused the reduction. Hospice initiation occurred relatively close to death, with a mean interval of 39.9 days and a median of 22.0 days, and some antibiotic treatment may have preceded hospice enrollment. In addition, cancer stage, treatment status, infection severity, microbiological findings, functional status, symptom burden, and treatment intent were unavailable in the claims data.
BACKGROUND: Antibiotic treatment remains common during end-of-life care for patients with cancer, despite uncertain benefits for survival and potential burdens including drug toxicity, intravenous administration, adverse effects, and antimicrobial resistance. This retrospective cohort study evaluated whether hospice involvement was associated with differences in broad-spectrum antibiotic use among adults with cancer during the final 3 months of life.
DETAILS: Investigators analyzed Korean National Health Insurance Service claims data for adults aged ≥18 years who died between January 1, 2018, and December 31, 2021, with one of the 10 leading cancer-related causes of death. Hospice users had received inpatient, home-based, or consultation-based hospice care before death. Broad-spectrum antibiotic exposure included anti-pseudomonal penicillins, anti-pseudomonal cephalosporins, carbapenems, and glycopeptides. The final 90 days of life were divided into four intervals: 1–3 months before death, 1 week to 1 month before death, the final week, and the final 3 days. Antibiotic exposure was assessed by the proportion of patients receiving antibiotics and by days of therapy (DOT) per 1,000 patient-days. Propensity score matching was performed at a 1:2 ratio.
After matching, 38,102 hospice users and 75,736 non-hospice users were analyzed. During the final 3 months of life, 74.6% of hospice users and 79.0% of non-hospice users received at least one broad-spectrum antibiotic (P0.001). Antibiotic use was initially slightly higher among hospice users during the period 1–3 months before death, at 34.0% versus 32.2% (P0.001), but became consistently lower among hospice users thereafter. From 1 week to 1 month before death, use was 31.1% versus 32.8%; during the final week, 11.3% versus 18.5%; and during the final 3 days, 4.8% versus 10.3% among hospice and non-hospice users, respectively (all P0.001).
Days of therapy per 1,000 patient-days were also consistently lower among hospice users, with the greatest differences occurring during the final week and final 3 days of life. Carbapenems and glycopeptides demonstrated particularly pronounced differences between the groups. In cancer-specific analyses, patients with hematologic malignancies had the highest overall antibiotic exposure, followed by those with pancreatobiliary and gastric cancers, while exposure was comparatively lower among patients with breast and liver cancers.
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Source: Jeung, Y. S., Kim, H. J., Yu, J., et al. Comparison of Broad-Spectrum Antibiotic Use According to Hospice Utilization Among Patients with Cancer at the End of Life in South Korea: A Nationwide Analysis. Journal of Hospice and Palliative Care. 2026; 29(2): 41-50. Published: June 1, 2026. DOI: 10.14475/jhpc.2026.29.2.41.
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