Hepatocellular carcinoma (HCC) is the sixth most common malignancy and the third leading cause of cancer-related death worldwide. Contemporary advances in systemic and locoregional therapies have led to changes in peer-reviewed guidelines regarding systemic therapy as well as the possibility of downstaging disease that may enable some patients with advanced disease to ultimately undergo partial hepatectomy

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Understanding the health impacts of local, culturally relevant diets will be critical to advancing precision nutrition across diverse populations in a sustainable way.

To fully harness precision medicine and transform cancer care for the better will require a strategic shift to highly personalized interventions that embrace innovation and adaptability.

Correction to: Nature Medicine https://doi.org/10.1038/s41591-025-03560-7, published online 5 March 2025.

Addendum to: Nature Medicine https://doi.org/10.1038/nm.1930, published online 15 February 2009.

This fifth article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to systematic reviews, clinical practice guidelines, and health technology assessments and addresses issues of indirect evidence. Guideline developers and health technology assessment practitioners must carefully specify the population, intervention, comparison

Objective To determine the incidence and prevalence of dementia in a nationally representative cohort of US Medicare beneficiaries, stratified by important subgroups. Design Population based study. Setting Nationwide study between 2015 and 2021. Participants Fee-for-service Medicare beneficiaries aged 66 or older with at least one year of continuous enrollment. Main outcome measures Incidence and prevalence

As people live longer with dementia, we must balance the benefits and harms of medical interventions to meet unique individual needs, writes Jay B Lusk Much attention has been paid to the development of new drug treatments for Alzheimer’s disease. Interventions to target the pathophysiology of the most common form of dementia are essential to tackle its rising public health burden. Amid intense debates

In the early 1980s a well dressed woman in high heels entered a police station in Birmingham. She had come to see a police officer who had become violent and had had to be restrained by colleagues. He was now locked in one of his own cells. On her arrival she was asked, “Where’s the psychiatrist?” Paula Salmons responded, “I am the psychiatrist.” Women were then in the minority in psychiatry and Salmons

Husain describes the need for closer collaboration between universities and NHS organisations.1 At the heart of this struggling relationship are financial pressures, with partnered institutions essentially competing for clinical trials as a potential source of income. Clinical trials research is key to improving patient care and belongs in the NHS,2 while universities drive innovation and knowledge

Novel interventions are needed to tackle a public health crisis Annually, there are more than 82 million cases of gonorrhoea worldwide.1 In 2023, England recorded more than 85 000 gonorrhoea diagnoses—the highest annual incidence since records began in 1918 and a threefold increase since 2012.2 This dramatic rise in case numbers is not limited to the UK: in Europe notification rates increased by more

Using routine data to uncover underlying trends presents challenges Population estimates of dementia have, in recent decades, become of national interest to policy makers, politicians and the wider community. In a linked study (doi:10.1136/bmj-2024-083034), Blass and colleagues report estimates of the incidence and prevalence of dementia in the US Medicare fee-for-service health insurance system for

Siddhanth Sharma and colleagues argue that adaptation to cope with the health effects of climate change requires more focused local data and dedicated funding Climate change is often called “the greatest 21st century health threat.”1 Substantial and growing evidence shows its harmful effects on health through various pathways, including heat stress, drought, and shifting infectious disease patterns

### What you need to know Gonorrhoea is of increasing concern for global sexual health. Continued stigmatisation of sexual health, particularly for those in marginalised communities, contributes to increasing incidence, greater complexity of cases, and the rise of multidrug resistant strains.1 Antimicrobial resistance (AMR) limits treatment options. Condoms are highly effective at preventing transmission

“If you take a sick child from its parents or nurse you break its heart immediately,” wrote physician George Armstrong in 1792. Mary Lindsay took these words to heart and throughout her seven decades as a paediatrician she campaigned for children staying in hospital to be accompanied by their parents. When she began practising in the early 1950s, visiting hours were severely restricted, based on misconceptions

Goodyear and colleagues argue that smartphone and social media regulation must go beyond bans.1 As a GP, I have noticed that mental health consultations with teenagers are on the rise. Depression, lack of meaning, and body dissatisfaction are the main topics of discussion. Female teenagers’ mental health has plummeted, with hospital admissions for self-harm and suicidality rising 112.8% between 2012-23

Obesity remains defined by the flawed metric at the heart of its diagnosis—BMI. Carla Delgado reports on the fresh attempts to move away from this, as weight loss drugs usher in a new age for the obesity crisis The explosion in popularity of weight loss drugs such as semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) has brought a twist to the management of obesity. Patients usually

Scrap means testing for personal care and regulate care home charges The care home market in the UK is characterised by rising fees, inadequate capacity, and deteriorating care standards.12345 As governments in England and Scotland review how care is funded, lessons can be learnt from the Scottish model, which since 2002 has offered free personal and nursing care to people over 65. The Scottish parliament’s

World Health Assembly in 2025 presents a renewed opportunity The World Health Organization’s latest estimates on trends and causes of maternal mortality are sobering.12 Despite decades of socioeconomic progress and accumulated knowledge on how to prevent maternal deaths, the global burden is stubbornly high—and in some areas, it is worsening. Maternal mortality in sub-Saharan Africa remains disproportionately

After publication, by Inoue and colleagues ( BMJ 2024;386:e079377, doi:10.1136/bmj-2024-079377), the authors spotted a coding error. Specifically, the original code did not appropriately use the out-of-bag prediction in the …

This editorial ( BMJ 2024;386:q1807, doi:10.1136/bmj.q1807) has …

Consultant anaesthetist Mary Doherty talks to Kathy Oxtoby about being autistic and being a doctor *Print headline* Role model: Mary Doherty When Mary Doherty was diagnosed as autistic in 2013, in her mid-40s, “looking back it explained so much of my life.” “But the question then was, ‘Can you be autistic and be a doctor?’” says Doherty, a clinical associate professor at University College Dublin School

BACKGROUND Nerandomilast (BI 1015550) is an orally administered preferential inhibitor of phosphodiesterase 4B with antifibrotic and immunomodulatory properties. Nerandomilast has been shown to slow the progression of idiopathic pulmonary fibrosis, but an assessment of its effects in other types of progressive pulmonary fibrosis is needed. METHODS In a phase 3, double-blind trial, we randomly assigned

This Viewpoint discusses the need to develop products, such as long-acting antiretrovirals, for people with HIV in settings with minimal resource requirements.

ImportanceImmune thrombotic thrombocytopenic purpura (iTTP) is a life-threatening thrombotic microangiopathy that presents with microangiopathic hemolytic anemia (MAHA) and thrombocytopenia. Worldwide annual incidence of iTTP is 2 cases per million to 6 cases per million.ObservationsImmune TTP is caused by an autoantibody to a disintegrin and metallopeptidase with thrombospondin type 1 motif 13 (ADAMTS13)

BACKGROUND Nerandomilast (BI 1015550) is an orally administered preferential inhibitor of phosphodiesterase 4B with antifibrotic and immunomodulatory effects. In a phase 2 trial involving patients with idiopathic pulmonary fibrosis, treatment with nerandomilast stabilized lung function over a period of 12 weeks. METHODS In this phase 3, double-blind trial, we randomly assigned patients with idiopathic

BACKGROUND Each year, millions of pulmonary nodules are identified incidentally or through lung cancer screening, and many involve biopsy to distinguish cancer from benign processes. Both navigational bronchoscopy and computed tomography-guided transthoracic needle biopsy are commonly used in patients undergoing biopsies of peripheral pulmonary nodules, but the relative diagnostic accuracy of these

BACKGROUND Prednisone is currently recommended as the first-line treatment for pulmonary sarcoidosis but is associated with many side effects. Methotrexate, which is recommended as a second-line treatment, appears to have fewer side effects than prednisone but a slower onset of action. Data are needed on the efficacy and side-effect profile of methotrexate as compared with prednisone as first-line

Importance Individuals at risk for chronic obstructive pulmonary disease (COPD) but without spirometric airflow obstruction can have respiratory symptoms and structural lung disease on chest computed tomography. Current guidelines recommend COPD diagnostic schemas that do not incorporate imaging abnormalities. Objective To determine whether a multidimensional COPD diagnostic schema that includes respiratory

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Three translational studies reveal elevated mitochondrial metabolism as a driver of age-related clonal hematopoiesis and suggest that targeting this process — for example, with metformin — could reduce the risk of associated diseases.

Vulvar and vaginal cancers represent rare malignancies, with an incidence of 2.7 per 100,000 women for vulvar cancer, predominantly affecting women older than 60 years, although rising rates are observed in younger demographics. Approximately 90% of vulvar cancers are squamous cell carcinoma and frequently are associated with human papillomavirus (HPV) infection. Vaginal cancer, constituting less than

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BackgroundGenetic studies have established angiopoietin-related protein 4 (ANGPTL4) as a key regulator of triglyceride metabolism and a promising target to reduce atherosclerotic cardiovascular disease (ASCVD) risk beyond traditional risk factors. Human ANGPTL4 loss-of-function shows no adverse consequences and is associated with reduced triglycerides and remnant cholesterol, and a reduced risk of

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