Use of Point-of-Care Subepidermal Moisture Devices To Detect Localised Oedema and Evaluate Pressure Injury Risk
Nurses recognise the value of objective measures in determining the risk of pressure injury and are the primary end-users of point-of-care subepidermal moisture devices. However, standardising procedural instructions and interpretive criteria to guide preventative measures requires further research.
KEY FINDINGS: Nurses recognise the value of objective measures in determining the risk of pressure injury and are the primary end-users of point-of-care subepidermal moisture devices. However, standardising procedural instructions and interpretive criteria to guide preventative measures requires further research. International pressure injury clinical practice guidelines advocate for subepidermal moisture devices as an adjunct to routine clinical skin assessment, although little is known about bedside use. This scoping review reveals low adoption of such devices and the need to develop standardised procedures in their use and interpretation.
BACKGROUND: Purpose of the study is to map current literature on bedside clinicians' use of point-of-care subepidermal moisture devices to identify increased pressure injury risk. Pressure injuries are a substantial healthcare burden. Localised oedema occurs before visible or palpable changes, and therefore is a biomarker of increased pressure injury risk. Novel bedside technologies that detect localised oedema may aid early pressure injury preventative practices.
DETAILS: Arksey and O'Malley's six-step framework and the PRISMA-ScR guidelines guided this scoping review. CINAHL Complete, Embase, SCOPUS, Cochrane (wounds) and PubMed databases were searched for primary research and quality improvement projects published in English between 2008–2022. Included studies focused on clinicians' bedside use of subepidermal moisture devices to quantify localised oedema and pressure injury risk. The PAGER framework supported narrative synthesis of the extracted data. Nine studies were selected from 1676 sources. Two point-of-care subepidermal moisture devices were identified in clinical use, largely by nurses. Inconsistent use and interpretations revealed significant knowledge gaps in clinical practice. Additionally, no included studies engaged patients or the public in their design.
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Source: McLaren-Kennedy, A., Chaboyer, W., Carlini, J., et al. (2023). Use of Point-of-Care Subepidermal Moisture Devices To Detect Localised Oedema and Evaluate Pressure Injury Risk: A Scoping Review. J Clin Nurs. 2023; 32(17-18): 5478-5492. Published: September, 2023. DOI: 10.1111/jocn.16630.
Microscopic Colitis Is Associated With an Increased Risk of Dementia in a Swedish Population
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.
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).
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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.
Factors Associated With Lactation Outcomes Among Mothers of Infants With Congenital Heart Disease
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.
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).
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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.
Effects of Continuous Glucose Monitoring on Impaired Awareness of Hypoglycemia in Older Adults With Type 1 Diabetes
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.
Summary
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.
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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.
Medical Management and Revascularization for Asymptomatic Carotid Stenosis
Among patients with high-grade stenosis without recent symptoms, the addition of stenting led to a lower risk of a composite of perioperative stroke or death or ipsilateral stroke within 4 years than intensive medical management alone. Carotid endarterectomy did not lead to a significant benefit.
KEY FINDINGS: Among patients with high-grade stenosis without recent symptoms, the addition of stenting led to a lower risk of a composite of perioperative stroke or death or ipsilateral stroke within 4 years than intensive medical management alone. Carotid endarterectomy did not lead to a significant benefit.
BACKGROUND: Improvements in medical therapy, carotid-artery stenting, and carotid endarterectomy call into question the preferred management of asymptomatic carotid stenosis. Whether adding revascularization to intensive medical management would provide greater benefit than intensive medical management alone is unclear.
DETAILS: Authors conducted two parallel, observer-blinded clinical trials that enrolled patients with high-grade (>=70%) asymptomatic carotid stenosis across 155 centers in five countries. The stenting trial compared intensive medical management alone (medical-therapy group) with carotid-artery stenting plus intensive medical management (stenting group); the endarterectomy trial compared intensive medical management alone (medical-therapy group) with carotid endarterectomy plus intensive medical management (endarterectomy group). The primary outcome was a composite of any stroke or death, assessed from randomization to 44 days, or ipsilateral ischemic stroke, assessed during the remaining follow-up period up to 4 years. A total of 1245 patients underwent randomization in the stenting trial and 1240 in the endarterectomy trial. In the stenting trial, the 4-year incidence of primary-outcome events was 6.0% (95% confidence interval [CI], 3.8 to 8.3) in the medical-therapy group and 2.8% (95% CI, 1.5 to 4.3) in the stenting group (P=0.02 for the absolute difference). In the endarterectomy trial, the 4-year incidence of primary-outcome events was 5.3% (95% CI, 3.3 to 7.4) in the medical-therapy group and 3.7% (95% CI, 2.1 to 5.5) in the endarterectomy group (P=0.24 for the absolute difference). From day 0 to 44, in the stenting trial, no strokes or deaths occurred in the medical-therapy group and seven strokes and one death occurred in the stenting group; in the endarterectomy trial, three strokes occurred in the medical-therapy group and nine strokes occurred in the endarterectomy group.
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Optical Feedback for Safe Automatic Laser Lithotripsy
The developed optical guidance system provides real-time feedback during laser lithotripsy, improving safety and precision by reducing the risk of accidental tissue damage. The proposed technology is expected to enhance outcomes in minimally invasive urological laser procedures.
Summary
Tissue Sensor Implementation in a Clinical System
[Posted 20/Jan/2026]
AUDIENCE: General Surgery, Nephrology, Internal Medicine
KEY FINDINGS: The developed optical guidance system provides real-time feedback during laser lithotripsy, improving safety and precision by reducing the risk of accidental tissue damage. The proposed technology is expected to enhance outcomes in minimally invasive urological laser procedures.
BACKGROUND: Purpose of this study is to develop an optical feedback system compatible with a commercial surgical laser for automatically distinguishing between urinary stones and soft tissues during laser lithotripsy, thereby enhancing procedural safety.
DETAILS: The system, based on diffuse reflectance spectroscopy (DRS), was implemented in an engineered clinical theranostic platform. In vivo experiments were conducted to collect and analyze DRS spectra of tissues during laser lithotripsy. Illumination was performed via the endoscope, and detection was performed via the treatment fiber. Classification of urinary stones and soft tissues was performed using machine learning methods, i.e., Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA). The system demonstrated high diagnostic performance, with 93% sensitivity for soft tissue identification and 93% specificity for stone detection evaluated by the LDA method. This real-time differentiation effectively minimized unintended laser exposure to non-target tissues.
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Source: Korneva, N., Budylin, G., Tseregorodtseva, P., et al. Optical Feedback for Safe Automatic Laser Lithotripsy: Tissue Sensor Implementation in a Clinical System. Lasers Surg. Med.. 2026; 58(1): 38-48. Published: January, 2026. DOI: 10.1002/lsm.70081.
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