[Posted 30/Oct/2023]

AUDIENCE: Family Medicine

KEY FINDINGS: Severe erythrocytosis (hematocrit >54%) is a rare outcome of gender-affirming testosterone therapy. Clinical recommendations should reconsider the need for routine frequent erythrocytosis screening within the first year of testosterone therapy for patients who prefer to minimize laboratory draws.

BACKGROUND: Gender-affirming hormone therapy (GAHT) is safe overall, with few adverse effects. One potential effect from using testosterone for GAHT is an increase in hemoglobin and/or hematocrit, known as secondary erythrocytosis. Current guidelines recommend monitoring hemoglobin or hematocrit routinely in the first year, some as frequently as every 3 months, which can create barriers to care. The study explored the incidence of erythrocytosis in the first 20 months of testosterone therapy among people receiving gender-affirming care.

DETAILS: This is a descriptive fixed cohort study of hematocrit and hemoglobin data from the charts of 282 people taking testosterone for GAHT. During the first 20 months of testosterone therapy, the cumulative incidence of hematocrit >50.4% was 12.6%, hematocrit >52% was 1.0%, and hematocrit >54% was 0.6%. All people were taking injectable testosterone cypionate, with a median dose of 100 mg weekly.

Copyright © Annals of Family Medicine, Inc. All rights reserved.

Source: Porat, A. T., Ellwood, M., Rodina, M., et al. (2023). Erythrocytosis in Gender-Affirming Care With Testosterone. Ann Fam Med. 2023; 21(5): 403-407. Published: September/October, 2023. DOI: 10.1370/afm.3018.

[Posted 5/Feb/2026]

AUDIENCE: Internal Medicine, Neurology

KEY FINDINGS: MC patients may be more vulnerable to dementia diagnosis in early disease course. The intriguing inverse association between MC and preexisting dementia implies a possible underdiagnosis of MC in demented population and warrants further investigation.

BACKGROUND: The microbiota-gut-brain axis has been implicated in dementia. Yet whether dementia is associated with microscopic colitis (MC), an age-related inflammatory colonic disease involving gut dysbiosis, remains unknown.

DETAILS: Using the nationwide ESPRESSO cohort in Sweden, authors compared MC patients histologically diagnosed 1990-2017 and aged >= 30 years to their population-based comparators and siblings, separately. MC association with incident and prevalent dementia diagnosis, respectively, was investigated in a matched cohort and a matched case-control design. Following 13,037 MC patients and 61,710 population comparators for a median of ~10 years, authors observed 4674 incident dementia cases (46% were Alzheimer's disease [AD]). During the first 5 years since biopsy, MC was associated with a 19% higher dementia risk (adjusted hazard ratio [aHR]: 1.19; 95% confidence interval [CI]: 1.07-1.32). This short-term association applied to both AD and vascular dementia and appeared stronger as compared to siblings (aHR: 1.55; 95% CI: 1.22-1.97). After 5 years, it attenuated to null in both comparisons, regardless of dementia subtype. Prior dementia was less prevalent in MC (adjusted odds ratio [aOR]: 0.73; 95% CI: 0.65-0.82). This inverse association was independent from medications commonly prescribed in MC but was not supported by sibling findings (aOR: 1.11; 95% CI: 0.81-1.51).

Copyright © John Wiley & Sons, Inc. All rights reserved

Source: Kang, X., Bergman, D., Sun, J., et al. Microscopic Colitis Is Associated With an Increased Risk of Dementia in a Swedish Population. Journal of Internal Medicine. 2026; 299(2): 216-227. Published: February, 2026. DOI: 10.1111/joim.70046.

[Posted 2/Feb/2026]

AUDIENCE: Nursing, Neonatology

KEY FINDINGS: Mothers of infants with CHD, especially primiparous or those with diabetes, should receive prenatal lactation education, prenatal access to breast pumps, and postnatal lactation support. Research should explore interventions to improve lactation outcomes among this group.

BACKGROUND: The prevalence of mother's own milk (MOM) feeding among infants with congenital heart defects (CHD) is low. Objective of this study is to examine associations between maternal, infant, and clinical practice factors and lactation outcomes among mothers of infants with CHD during the first 14 days postpartum. Dyads were eligible if the infant was born at the institution and the mother provided MOM for feeding. Bivariate analyses, linear regression, and logistic regression analyses were performed.

DETAILS: Of the 93 mothers enrolled, 90 (96.8%) achieved secretory activation (SA), 45 (50%) achieved coming to volume (CTV), and 31 (34.4%) achieved full lactation. Mean time to SA was 92.17 ± 44.95 hours. Multiparity was associated with reduced time to SA by 32.93 hours (95% CI, -49.16 to 16.69; P < .001). A cubic increase in pumping frequency on days 3 to 5 inversely affected time to SA (P = .002). Multiparity was associated with a 3.35 (95% CI, 1.1201-9.366) higher odds of achieving CTV (P = .021) and diabetes with a 0.126 (95% CI, 0.032-0.492) lower odds (P = .003). Odds of reaching full lactation were lower in women with Medicaid insurance (0.333, 95% CI, 0.125-0.0886; P = 0.28) and those with diabetes (0.182, 95% CI, 0.307-0.905; P = .037) and higher in multiparous women (5.437, 95% CI, 1.538-19.217; P = .009).

Copyright © The National Association of Neonatal Nurses. All rights reserved.

Source: Iapicca, L. C., Bendixen, M. M., Spatz, D. L., et al. Factors Associated With Lactation Outcomes Among Mothers of Infants With Congenital Heart Disease. Advances in Neonatal Care. 2025; 25(6): 607-616. Published: December, 2025. DOI: 10.1097/ANC.0000000000001315.

A Post Hoc Analysis of the WISDM Study.

[Posted 28/Jan/2026]

AUDIENCE: Endocrinology, Nephrology

KEY FINDINGS: In older adults with type 1 diabetes, CGM improves hypoglycemia; however, its role in improving IAH is variable, depending on the scoring method. This study highlights the limitations of the Clarke score.

BACKGROUND: Although continuous glucose monitoring (CGM) reduces hypoglycemia and may improve impaired awareness of hypoglycemia (IAH), its effectiveness in older adults at high risk remains unknown.

DETAILS: This post hoc analysis of the WISDM study focuses on CGM use over 52 weeks. IAH was assessed using the Clarke original score (Clarke-full) and its subscales, Hypoglycemia Awareness Factor (HAF) and Severe Hypoglycemia Experienced Factors (SHEF), at baseline, 26 weeks, and 52 weeks. After 26 weeks (n = 184) and 52 weeks (n = 94) of CGM use, Clarke-SHEF decreased significantly (P = 0.02 and P < 0.0001, respectively), whereas Clarke-full and Clarke-HAF remained unchanged. After 52 weeks, Clarke-full but not Clarke-HAF improved in the IAH subgroup, highlighting the importance of selecting the appropriate scoring method for IAH.

Copyright © American Diabetes Association. All rights reserved.

Source: Bilal, A., Yi, F., Whitaker, K., et al. Effects of Continuous Glucose Monitoring on Impaired Awareness of Hypoglycemia in Older Adults With Type 1 Diabetes: A Post Hoc Analysis of the WISDM Study. Diabetes Care . 2026; 49(1): 86-91. Published: January, 2026. DOI: 10.2337/dc25-0971.

[Posted 27/Jan/2026]

AUDIENCE: Dermatology, Endocrinology

KEY FINDINGS: This research provides the first comprehensive, high-resolution molecular atlas of the human facial sebaceous gland. By decoding the dynamic process of sebocyte differentiation and identifying site-specific gene markers, the study offers a critical reference for future investigations into the pathophysiology of acne and other sebaceous-related disorders, potentially identifying new therapeutic targets.

BACKGROUND: The sebaceous gland (SG) is a critical component of the pilosebaceous unit (PSU), responsible for producing sebum that maintains skin homeostasis through lubrication and barrier protection. Pathological dysregulation of SG activity is central to several common dermatological conditions, including acne vulgaris, seborrheic dermatitis, and various forms of alopecia. Historically, our understanding of human SG molecular biology has been limited by a heavy reliance on murine models, which do not fully mirror human physiology, and the technical difficulty of analyzing mature sebocytes, which often rupture during standard single-cell processing.

DETAILS: This study utilized a multi-omic approach to dissect the human SG at cellular resolution:

• Study Population: Facial skin samples were obtained from $n=3$ healthy female White donors between the ages of 49 and 57 years.
• Technological Integration: The researchers integrated Stereo-seq (spatial transcriptomics) with single-cell RNA sequencing (scRNA-seq) and validated findings using multiplexed error-robust FISH (MERFISH).
• Resolution: Stereo-seq provided high-resolution mapping with a bin size of 50, corresponding to approximately 25 µm cell diameter, allowing for the capture of transcriptomic profiles while preserving spatial orientation.
• Cellular Mapping: A total of 9,374 cells were analyzed, identifying various clusters including basal sebocytes, differentiating sebocytes, and "bursted" sebocytes representing holocrine secretion remnants.

The study yielded several significant molecular insights into the human SG:

• Differentiation Stages: Researchers identified four distinct stages of sebocyte differentiation, each characterized by a unique transcriptomic signature.
• Novel Genetic Markers: New markers for basal sebocytes were identified, including NNAT, IL-1R2, TINAGL1, and WFDC2. Additionally, S100A7, S100A8, S100A9, TYMP, and SERPINB4 were pinpointed as more effective markers for infundibular keratinocytes than traditional markers like K79.
• Signaling Pathways: Cyclophilin A (CyPA) was identified as a dominant autocrine signaling pathway within the SG. A previously unreported immune interaction was discovered where CD6, secreted by immune cells, is received by basal sebocytes via the ALCAM receptor.
• Spatial Dynamics: Unlike the anticipated radial pattern, differentiation was observed to progress apically from the gland's edge toward the sebaceous duct.

Copyright © Skyscape Editorial Team. All rights reserved.

Source: Düz, T., Torocsik, D., Simmering, A., et al. et al. High-Resolution Spatial Map of the Human Facial Sebaceous Gland Reveals Marker Genes and Decodes Sebocyte Differentiation. J Invest Dermatol.. 2026; 146(1): 40-54. Published: January, 2026. DOI: 10.1016/j.jid.2025.04.041.

A Systematic Review and Meta-Analysis.

[Posted 23/Jan/2026]

AUDIENCE: Psychiatry, Family Medicine

KEY FINDINGS: Results of this systematic review and meta-analysis suggest that depressive disorders, anxiety disorders, PTSD, and sleep disorders were associated with an increased risk of ACS. Particularly, PTSD and sleep disorders emerged as significant risk factors for ACS, indicating the potential impact of sleep quality on cardiovascular outcomes. Future research addressing these limitations could provide more nuanced insights into the association between mental health and ACS.

BACKGROUND: Aim of this study is to estimate the association of ACS among patients with mental disorders, as compared with patients without mental disorders.

DETAILS: Study screening was performed in duplicates with conflicts resolved upon consensus. Inclusion criteria were as follows: (1) observational or randomized study, (2) measured association with ACS (incident events, risk ratio, odds ratio, hazard ratio [HR]), and (3) investigated any clinical mental disorder (based on DSM and International Classification of Diseases) before ACS events. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Data extraction was performed in duplicate and resolved on consensus. Data were quantitatively synthesized through random-effects meta-analysis. The National Institutes of Health Study Quality Assessment Tools were used to assess the quality of included studies. Studies were analyzed from January 1966 to October 2021. Among 3616 initially identified studies, 25 full-text articles met inclusion criteria with 22,048,504 participants of median (IQR) age 48.0 (34.5-56.1) years, with 13 019 897 males (59.1%). Depressive disorder (HR, 1.40; 95% CI, 1.11-1.78; P = .01; Grading of Recommendations Assessment, Development, and Evaluation [GRADE] certainty = very low), anxiety disorder (HR, 1.63; 95% CI, 1.40-1.89; P < .001; GRADE certainty = low), sleep disorder (HR, 1.60; 95% CI, 1.22-2.10; P < .001; GRADE certainty = low), and posttraumatic stress disorder (PTSD; HR, 2.73; 95% CI, 1.94-3.84; P < .001; GRADE certainty = moderate) were associated with increased risk of ACS. Bipolar (HR, 1.48; 95% CI, 0.47-4.61; P = .28; GRADE certainty = very low) and psychotic (HR, 0.97; 95% CI, 0.01-178.30; P = .06; GRADE certainty = very low) disorders were not significantly associated with increased risk of acute myocardial infarction, although they had similar point estimates to some other mental disorders.

Copyright © American Medical Association. All Rights Reserved.

Source: Gupta, A., Tejpal, T., Seo, C., et al. Mental Disorders as a Risk Factor of Acute Coronary Syndrome: A Systematic Review and Meta-Analysis. JAMA Psychiatry.. Published: January 14, 2065. DOI: 10.1001/jamapsychiatry.2025.4253.