Kuang-Ming Liao, Jheng-Yan Wu, Chih-Cheng Lai
A multimodal strategy consisting of early primary closure supported by continuous negative-pressure irrigation and drainage was associated with accelerated wound healing and improved early wound appearance. E-value analysis suggested that unmeasured confounding is unlikely to fully explain the observed association, though residual confounding from selection bias cannot be excluded.No increase in adverse events was observed. Due to the retrospective design and relatively small sample size, these findings are hypothesis-generating. Prospective randomized trials are required to establish definitive clinical recommendations.
Tuberculosis remains a leading cause of illness and death worldwide, and individuals with type 2 diabetes have an increased risk of developing this infection. However, whether different glucose-lowering medications influence this risk is unclear. Here we show that use of glucagon-like peptide-1 receptor agonists is associated with a lower risk of tuberculosis compared with several commonly prescribed alternatives. We conducted a multicenter cohort study using TriNetX electronic health records from 143 healthcare organizations across multiple countries between 2017-2025. Patients receiving glucagon-like peptide-1 receptor agonists were compared with those receiving sulfonylureas, metformin, dipeptidyl peptidase-4 inhibitors, or sodium-glucose cotransporter-2 inhibitors. Propensity score matching and time-to-event analyses were applied over up to 5 years of follow-up. Use of glucagon-like peptide-1 receptor agonists is consistently associated with reduced tuberculosis risk compared with other agents. Incidence rates per 1,000 person-years ae lower than with sulfonylureas (0.68 vs 1.67; hazard ratio 0.53, 95% confidence interval 0.47-0.59), metformin (0.65 vs 1.31; 0.60, 0.51-0.70), dipeptidyl peptidase-4 inhibitors (0.73 vs 1.71; 0.49, 0.43-0.56) and sodium-glucose cotransporter-2 inhibitors (0.89 vs 1.02; 0.82, 0.72-0.92). These findings suggest that this class of medications may provide additional protection against tuberculosis in patients with type 2 diabetes.