After a fragility fracture, one in five women fractured again within two years and fewer than one in five were treated

The edition in brief

In 467,721 US women aged 50 and over with a new clinical fracture, 19.4% had another fracture within 24 months, rising to 27.8% after a vertebral fracture, yet only 17.5% started osteoporosis treatment. In SAVE-O2 AI, 300 acutely ill inpatients on oxygen were randomised to automated or manual titration; automated titration kept saturation in the 90 to 96% range 85% of the time versus 63%, and roughly halved time spent hypoxaemic. A meta-analysis of randomised trials found intensive glucose lowering made little or no difference to new diabetic neuropathy (OR 0.93, 0.85 to 1.02), with weaker signals for blood pressure control and multifactorial care. Pooling 21 studies, patient navigation, reminders to patients or clinicians, and automated referral each raised colonoscopy completion after a positive faecal test, from about 48% to 69%. Five trials found 14-day tegoprazan-amoxicillin dual therapy eradicated H. pylori as well as bismuth quadruple therapy (RR 0.996). The pearl covers routine daily bloods in stable inpatients.