When Lyme disease shows up in the eye, the diagnosis can be the hardest part
This CDC Emerging Infectious Diseases report compiles a retrospective case series of ocular Lyme disease spanning 1988–2025. While details are limited in the feed text, the focus is on how Borrelia infection can present with eye involvement across a long time window, underscoring that Lyme is not only a joint-and-neurology story but can manifest in organ-specific ways that complicate recognition and management.
Why it might matter to you:
Infectious diseases frequently intersect with hepatology and GI practice via systemic symptoms, immune phenomena, and medication choices—ocular involvement is another reminder that atypical presentations can delay correct workup. Case-series syntheses like this can help sharpen differential diagnosis when patients have multi-system complaints or unclear exposure histories, and may influence referral and testing pathways.
Cholangiocarcinoma’s cholesterol problem—and a kinase that may tie it to treatment response
This Gut piece frames cholangiocarcinoma (CCA) as an increasingly consequential, highly lethal biliary malignancy often diagnosed late, with limited benefit from current systemic therapy due to marked molecular heterogeneity. It highlights Aurora kinase B as a potential mechanistic “nexus” connecting cholesterol metabolism to therapy response, pointing to metabolic vulnerabilities that could be leveraged to refine stratification and treatment approaches in CCA.
Why it might matter to you:
If you care for patients with biliary disease or follow CCA developments, metabolism-linked biomarkers and targets could shape how risk and likely response are assessed beyond standard histology and staging. The emphasis on a cholesterol–signaling axis also suggests testable hypotheses for combination strategies and may inform discussions with oncology teams about emerging therapeutic directions.
In cirrhosis and chronic pain, opioid “deprescribing” looks stubbornly similar to everyone else’s
Using a large Medicare fee-for-service cohort (N=800,763) of adults ≥65 years on continuous opioids for at least 90 days, this retrospective study examined opioid discontinuation (a >30-day refill gap) and tapering (≥35% decrease in daily morphine milligram equivalents), comparing people without cirrhosis to those with compensated or decompensated cirrhosis. At one year, discontinuation rates were similar across groups (~36–37%). Calendar year mattered: deprescribing was higher pre–COVID-19, especially among those without cirrhosis, and factors such as non-opioid analgesic use, fall history, and frailty were associated with higher odds of tapering.
Why it might matter to you:
In liver disease clinics, opioid risk–benefit decisions are often constrained by limited alternative analgesics and higher vulnerability to adverse events. These real-world patterns suggest that “high-risk” status alone may not translate into higher tapering or discontinuation, which has implications for how you design pathways that integrate pain management, frailty/fall risk screening, and safer non-opioid strategies.
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