Simple prompts raised follow-up colonoscopy after a positive stool test from 48% to 69%

The edition in brief

Today's internal medicine edition closes on the abnormal stool test that never reaches colonoscopy. Across 21 studies and 19,613 patients, follow-up colonoscopy after a positive faecal immunochemical or occult blood test rose from a pooled 47.8% to 69.1% with interventions; patient navigation (RR 1.24), patient reminders (1.32), clinician reminders (1.36) and automated gastroenterology referral (1.68) were each associated with higher completion, though heterogeneity was often high. The 2026 British Society for Rheumatology guideline on polymyalgia rheumatica replaces the 2009 version, adding options for a faster steroid taper, early methotrexate, IL-6 receptor antagonists for those who cannot taper, and bone protection for everyone. In 24,803 surgical patients, a protocol of physician referral for preoperative sodium below 130 mmol/L made no difference to 30-day mortality, ICU admission or length of stay; a possible effect on one-year mortality may reflect treating the underlying disease. A meta-analysis of randomised trials found intensive glycaemic control made little or no difference to incident diabetic neuropathy (OR 0.93, 0.85 to 1.02). The pearl covers the speed limit for correcting chronic hyponatraemia.