The rapid expansion of private testosterone prescribing risks extending treatment beyond men with clearly defined need to people with non-specific symptoms and borderline test results, for whom the balance of benefit and long term risk are less certain, warn experts in The BMJ today.

Scleroderma (systemic sclerosis) is a rare, chronic, autoimmune disease that causes the body to produce too much collagen, leading to the hardening and thickening of the skin and internal organs. For more than 50 years, physicians have relied on manually pinching the skin to assess its thickness, a subjective approach that remains central to the diagnosis of systemic sclerosis, assessment of disease extent and progression, and monitoring of response to treatment. Despite being the accepted standard practice, doctors can score the same patient differently based on their own unique touch and judgement, making it difficult to accurately track changes in skin thickening over time or assess a patient’s response to treatment.

 

For the first time, researchers at Boston University Chobanian & Avedisian School of Medicine and the Boston University Department of Biomedical Engineering have developed and tested a camera-based technique called spatial frequency domain imaging (SFDI) to assess skin changes in scleroderma patients. SFDI works by shining patterns of harmless light on the skin, without touching it, and measuring how the light bounces back. “We have been developing SFDI for almost 15 years in my lab, but this is the first time anyone has applied this technology to scleroderma” explained Darren Roblyer, PhD, professor of biomedical engineering and co-author on the manuscript.

Scientists and policymakers use scenarios called Shared Socioeconomic Pathways to project how today’s choices affect tomorrow’s world. But for complex subjects like public health, these intentionally simple scenarios don’t capture every complexity.

Researchers at UChicago Medicine have launched a first-of-its-kind clinical trial testing a new type of personalized cell therapy designed to help the body's own immune system recognize and destroy cancer cells. The study will evaluate the treatment's safety and early effectiveness in patients with metastatic ovarian cancer and several other advanced solid tumors.

Climate change is a global crisis and the search for solutions is increasingly technological. A new, 700-page volume edited by a sociologist from the University of California, Merced demonstrates that moving people, institutions and communities to act may be just as consequential as technological solutions to climate change. “The Oxford Handbook of Climate Action” gathers 39 chapters from over 60 top environmental and climate scholars around the world.

Continuous glucose monitors (CGMs) could transform diabetes management for millions of Americans with type 2 diabetes who don't take insulin, according to findings from new research published in the New England Journal of Medicine.

The clinical trial found that adults using CGMs spent approximately five additional hours each day within their target blood sugar range compared with those receiving routine care. Nearly twice as many CGM users also achieved an A1c level below 7%, a common treatment goal for people with diabetes.

CGMs use a small sensor worn on the body to continuously track glucose levels throughout the day and night. This allows patients to see how their blood sugar responds to food, physical activity and other daily habits, potentially helping them make more informed decisions about managing their diabetes.

“An estimated 20 million adults in the United States have type 2 diabetes and do not take insulin, and despite advances in treatment, many still still do not reach glycemic targets,” said first author Tamara Oser, MD, professor in the University of Colorado Anschutz Department of Family Medicine. “Over time, elevated blood sugar can increase the risk of serious health complications, including heart disease, kidney disease and vision loss, so it’s important we continue to improve care for everyone with diabetes.”

Tamara and her co-authors also found another significant finding: CGM users experienced significantly greater improvements in A1c, a measure of average blood sugar over approximately three months. The difference between the groups was 0.9 percentage points, greatly exceeding the threshold generally considered clinically meaningful.

Largest clinical trial of its kind

The study included 283 adults across 22 U.S. primary care practices who were followed for 26 weeks. It’s the first large-scale, multicenter randomized controlled trial to evaluate the effectiveness and safety of CGM in adults with type 2 diabetes who do not take insulin.

Unlike smaller previous studies, this trial exclusively enrolled patients receiving diabetes care through primary care practices, where most Americans with type 2 diabetes are treated. This approach makes the findings particularly relevant to everyday clinical care.