Published January 24, 2026

Morning Report — Not Your Typical Medical Newsletter

We get it, you see a lot of medical newsletters, so hear us out. Once a month, we’ll highlight important medical news sprinkled with witty commentary, fun facts, giveaways, and more… because learning should be fun! Subscribe to receive the Morning Report directly.

Rethinking Bacterial Vaginosis Management 

INFECTIOUS FINDINGS

Nearly a third of women of reproductive age grapple with bacterial vaginosis (BV), with most stuck in a relentless Groundhog Day of relapse. Despite antibiotic treatment, the infection roars back. Scientists have long sparred over the root of this stubborn resurgence, and a new study in The New England Journal of Medicine may finally deliver the smoking gun.

It takes two

What if clinicians treated women with BV and their sexual partners in tandem? That was the premise of an Australian randomized controlled trial involving 164 monogamous male-female couples. The Aussie researchers split the couples into two camps: one where women received standard care while their partners got oral and topical antibiotics, and a control group where only the women were treated.

“Crikey!” cried the Aussies, slamming the study’s emergency brake before completion. Women in the partner treatment group saw BV recurrence plummet to 35%, whereas the control crept to 63%. The verdict? BV is likely a sexually transmitted infection (STI).

What changed?  

Despite years of whisperings about BV’s STI status, past studies flopped at showing efficacy with partner treatment. Why? Investigators had overlooked a crucial battleground—the penis. This study course-corrected by prescribing men not just oral antibiotics but also a topical cream for the penile skin. 

Key takeaways 

This study recasts BV as an STI, suggesting that cure rates hinge on clearing the infection in both partners—with oral and topical antibiotics. And while the trial focused on heterosexual couples, the findings likely extend to women in same-sex relationships. The Melbourne Sexual Health Centre wasted no time revamping its BV treatment protocols. Meanwhile, the research team—aware that global guidelines adapt at a glacial pace—launched a website to steer male partner treatment and mitigate the BV boomerang effect. Your move, CDC.

For more education on bacterial vaginosis, check out this CME podcast: Treating Two: Partnering Up Against Bacterial Vaginosis Recurrence

Skip the Slow Start in LDL-C Lowering 

CARDIO CORNER

“Start low and go slow”—the rallying cry of cautious pharmacology works well—until it doesn’t. A new study questions whether this measured approach holds up in LDL-C reduction, especially for those at very high risk. Should combination lipid-lowering therapy be the opening move, instead of statin monotherapy followed by a long, anxious wait to see if the numbers behave? 

When patience isn’t a virtue

A new meta-analysis, published in Mayo Clinic Proceedings, makes a compelling case for rethinking the monotherapy default. Drawing on data from >100,000 high-risk patients across 14 studies, the research found that initiating treatment with a combination of statin plus ezetimibe led to significantly greater reductions in LDL-C levels than monotherapy alone. On average, LDL-C dropped an additional 13 mg/dL, and 85% of patients reached target levels below 70 mg/dL. Crucially, combination therapy also delivered an 18% relative risk reduction in major adverse cardiovascular events and up to a 49% drop in all-cause mortality in network analyses.

As with any meta-analysis, the included studies are a mixed bag of size, design, and rigor. But the consistency across these diverse cohorts lends credibility.

Key takeaways 

Cardiology leans on adages harder than a BBQ dad with a buzz, slinging life advice with grill tongs. While this study contradicts “start low and go slow,” it backs other go-tos: “the lower, the better—for longer,” and “the earlier, the better.” For patients already on the edge, the study suggests that a more aggressive, front-loaded approach with a statin plus ezetimibe may drive LDL-C down faster, hit targets sooner, and translate into real survival gains. The authors don’t tiptoe: “We recommend combination therapy should be considered the gold standard of treatment for these patients and included in all future treatment guidelines.” Because as they say, “Aggressive early beats desperate late,” and “There’s no statin strong enough to reverse a missed opportunity.”

For more education on cholesterol management, check out this CME activity: How I Manage Statin Reluctance and Other Challenges in Lipid Therapy

The H Factor Behind Gastric Cancer Prevention 

GI GIST

A new paper in Nature Medicine does what you wish every intern would do when dropping a catastrophic problem: offer a solution. The authors open with a stark projection—a sharp global rise in gastric cancer among adults under age 50. Then they pivot to an actionable fix to prevent the majority of cases: widespread screening and treatment for Helicobacter pylori. 

Gut check reveals common culprit

Researchers at the WHO International Agency for Research on Cancer (IARC) tapped global cancer and mortality data to project gastric cancer risk for those born between 2008 and 2017. The forecast: 15.6 million new cases worldwide in this group if prevention stays on autopilot. Then they asked the question that might change everything—how many of those cases are driven by H pylori infection? The answer: a staggering 76%. And you know the rest—a short course of antibiotics and a proton pump inhibitor can negate 100% of those infections.

There are limits, of course. The models assume H pylori rates stay flat, which may not hold. Data from low-income regions are patchy, and scaling up screening won’t be easy—logistics, resources, and access all get in the way.

Key takeaways 

H pylori is the canary in the coal mine—spot it early, wipe it out, and you can derail the path to gastric cancer, experts suggest. This spiral-shaped menace burrows in stomach linings and lingers for decades before triggering malignancy. The solution? Implement population-based H pylori screening and hit infections with short-course antibiotics and a proton pump inhibitor. The authors set out to equip policymakers with evidence strong enough to drive action—a feat with roughly the same success rate as giving a cat a bath. But the case is airtight: catch the infection, stop the cancer, and prevent a surge that doesn’t have to happen.

Low-Dose Relief in Osteoarthritis Care 

OSTEOARTHRITIS OUTCOMES

Sometimes Europeans get there first—printing books, perfecting public transit, and turning August into a collective out-of-office. And new research suggests they may have been ahead of the curve on something else: low-dose radiation therapy (LDRT) for osteoarthritis. This nonpharmacologic approach could offer real relief and improved mobility for patients who find limited benefit from standard therapies.

In a double-blind, randomized, placebo-controlled trial from Korea, researchers tested whether LDRT could relieve pain in mild-to-moderate knee osteoarthritis. More than 100 participants received either 0.3 Gy, 3 Gy, or a sham treatment over six sessions. After four months, the 3 Gy group pulled ahead, with 70% hitting responder criteria. The 0.3 Gy group barely edged out placebo (a nonsignificant 58% vs 42%), and that 42% placebo response—while high—reminds us that in osteoarthritis trials, belief can be as potent as biology.

A little radiation goes a long way

Patients may recoil at the word “radiation,” often equating any exposure with oncologic treatment levels, but principal investigator Dr. Byoung Hyuck Kim quickly dismantled that misconception. In osteoarthritis, he explained, the dose is a sliver of what’s used in oncology (<5%) and="" directed="" only="" at="" the="" joint—well="" clear="" of="" vital="" organs.="" the="" study="" reported="" zero="" radiation-related="" side="">

Key takeaways 

LDRT for osteoarthritis isn’t new—it finally has the rigorous, placebo-controlled evidence to back it up. Long used in European clinics, the therapy now comes with validation and greater insight into dosing, safety, and patient selection. Next up: extended follow-up to test durability, imaging studies to track joint changes, and larger trials to define when—and for whom—this approach fits best.

 
For more education on osteoarthritis, check out this CME activity: Metformin: A Fresh Angle for Treating Knee Osteoarthritis

Seven Steps for Reducing Plastic Consumption

LONGEVITY LEARNINGS

“I just want to say one word to you. Just one word—plastics.” Baby Boomers who took career advice from The Graduate made out pretty well. But the pendulum swung too far. A spoonful of microplastics and nanoplastics (MNPs) now live rent-free in the human brain, with even higher levels found in people with dementia. Plastic-free living may be unrealistic—the honey is already out of the plastic bear—but simple mitigation steps based on a recent review of the evidence may help reduce MNP intake.

Seven simple steps for minimizing MNP intake 

1. Switch from bottled to filtered/tap water to cut MNP intake from 90,000 to 4,000 particles/year.
2. Stop microwaving food in plastic to avoid releasing billions of MNPs into meals (up to 4.22 million microplastic and 2.11 billion nanoplastic particles/cm² in only three minutes).
3. Swap plastic tea bags for loose-leaf tea to prevent leaching trillions of particles into mugs.
4. Use a HEPA air filter to trap nearly 99.97% of airborne MNPs and reduce inhalation exposure.
5. Store food in glass or stainless steel instead of plastic containers.
6. Limit canned foods, which are lined with plastic coatings that contain bisphenol A (BPA) and can spike BPA levels by >1,000% in just five days.
7. Choose whole foods over processed ones, as items like chicken nuggets contain 30 times more microplastics than chicken breasts.

To be clear: 

Cutting MNP ingestion and consumption as outlined above makes sense, but clinical trials have yet to show if these steps will lead to a measurable drop in MNP buildup in the human body. 

Key takeaways

MNP ingestion and inhalation can sabotage cellular function and cripple organ systems through oxidative stress, inflammation, metabolic disruption, and carcinogenesis. Worse, these particles lurk in everything from food to cleaning supplies to beauty products. But let’s reclaim the keyboard from Debbie Downer. A reassuring finding from the study is the apparent disconnect between age and microplastic buildup, hinting that the body purges MNPs through sweat, urine, and feces—despite constant environmental assault. And patients may tilt the odds further by adopting the steps above. Number one—ditch the plastic water bottle. 

Click here to read the five remaining article summaries that rounded out our “Best of 2025” list. Study Debunks Digital Dementia in Older Adults Can One Therapy Session Have a Meaningful Effect? New Colonoscopy Prep Guidelines—A Movement in the Right Direction? Time to Loosen the Cap in HF Fluid Restriction? Rising Doubts About Non-Celiac Gluten Sensitivity