Questioning Medicine

Stavropoulou E, et al. Reassessing the 2023 International Society for Cardiovascular Infectious Diseases Duke clinical criteria for infective endocarditis: Impact of excluding fever and updating diagnostic definitions. Clin Infect Dis 2025 Dec 31; [e-pub]. DOI: 10.1093/cid/ciaf737 .    Big takeaways About 35% of patients truly had IE. Fever showed up in 80% of patients both with and without IE, so...

we look at CODE LVO and what does being frail even mean????? vaccines may not help baby and antibiotics still don't help viral illness

CME song --Check the Lytes

CME - sodium, potassium, calcium

  10.1016/j.jaip.2025.07.005 .40675327 All of the videos were found to be useful or very useful, 99% were of moderate or high reliability, and 99% had moderate to excellent educational quality   Prostate-specific antigen levels among participants receiving annual testing. JAMA Oncol 2025 Nov; 11:1341 10.1001/jamaoncol.2025.3386 .40965920 PSA levels at or above 4.0 ng/mL fell below that threshold o...

Wolfe R, Broder JC, Zhou Z, et al. Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 12 Aug 2025. [Epub ahead of print]. https://pubmed.ncbi.nlm.nih.gov/40796244/   Donocan LE et al. Closed-loop insulin delivery in type 1 diabetes in pregnancy: The CIRCUIT randomized clinical trial. JAMA 2025 Oct 24; [e-pub]. ( https://doi.org/...

Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction - https://www.nejm.org/doi/full/10.1056/NEJMoa2504735?query=WB     McGuire DK et al. Oral semaglutide and cardiovascular outcomes in high-risk type 2 diabetes. N Engl J Med 2025 Mar 29; [e-pub]. ( https://doi.org/10.1056/NEJMoa2501006 )   Interactive Virtual Presence to Remotely Assist Parents With Car Seat Installation ht...

https://pubmed.ncbi.nlm.nih.gov/40767818/ This is a great example for students and residents to look and see that the abstract does not always match what the paper actually says

Efficacy and safety of Baxdrostat in uncontrolled and resistant hypertension compared to placebo in phase three when there are MRA available that are cheap and available A randomised trial of physical therapy for meniscal tear and knee pain discovers that home exercises are just as good as inperson physical therapy a Pragmatic trial of glucocorticoids for community acquired pneumonia that I don't...

gabapentin may increase COPD exacerbations Benzo for ETOH might be long gone..guess what is going to replace it Anticoagulation after ablation.... what do you do with it? BBlocker in those with cirrhosis and varices

Clinicians should refer patients for liver transplant evaluation after any decompensation event —such as ascites or variceal bleeding— regardless of MELD score . After a first decompensation, 5-year mortality is 20–30% ; after a second, it rises to 80–90% . Refractory ascites carries a 50% 1-year mortality , and overt hepatic encephalopathy has a 25–40% 1-year mortality . After an initial variceal...

Study Summary: Emergent Carotid Stenting in Acute Stroke Thrombectomy A multicenter registry study in Catalonia (2017–2023) evaluated outcomes in 578 patients with acute ischemic stroke and tandem lesions (large-vessel occlusion plus extracranial carotid stenosis). Patients were divided into two groups: those who received emergent carotid artery stenting (E-CAS) and those who did not ( non-CAS )....

This massive meta-analysis of 484 randomized, double-blind, placebo-controlled trials (104,176 participants) quantified the blood pressure–lowering effects of major antihypertensive drug classes and their combinations. It introduces a new intensity-based classification system and an online calculator to predict BP-lowering efficacy based on drug, dose, and baseline BP. Study Design: 484 trials, 10...

Practice Pearls: “Skip Leg Day” (Sometimes) For PAD patients who can’t tolerate leg workouts, upper body aerobic training is a strong, evidence-backed alternative . It’s not just a workaround—it’s a workout. Citation Ahiskali GN, Demirel A, Yamikan H, Kutukcu EC. The Effects of Upper Extremity and Lower Extremity Aerobic Exercise Training in Patients with Peripheral Arterial Disease: A Systematic...

GLP1 drugs work but they likely need lifestyle modifications No convincing evidence GLP1 cause thyroid cancer in humans BUT contraindication if family history exist Stopping therapy usually results in weight gain Insurance coverage for weight loss is limited and variable  Semaglutide for type 2 diabetes max dose is 2.0 mg weekly Semaglutide for weight loss has a goal dose of 2.4 mg weekly Diagnose...

OMED COPD CME

All of these articles have been talked about on questioning medicine social media on tik tok and instagram but here is an update of my recent reading

Buelt, Andrew | 2:13 PM (1 hour ago) |  | to me https://jamanetwork.com/journals/jama/fullarticle/2833338   Conclusions and Relevance   These results support use of metformin for treatment of symptomatic knee osteoarthritis in people with overweight or obesity. Because of the modest sample size, confirmation in a larger clinical trial is warranted.         Lee S et al. Live zoster vaccination and...

https://www.nejm.org/doi/10.1056/NEJMoa2504544     During follow-up ranging from 12 to 52 weeks, fewer patients had severe exacerbations in the albuterol/budesonide group than in the albuterol group (5% vs. 9%). Patients in the albuterol/budesonide group had less than half the total exposure to systemic glucocorticoids as those in the albuterol group (mean, 23 vs. 62 mg per year).     Clinical Pra...

https://publications.aap.org/pediatrics/article/156/1/e2024070175/202234/Infant-Antibodies-After-Maternal-COVID-19?autologincheck=redirected   Objective: The study aimed to evaluate the kinetics and duration of maternally derived antibodies in infants up to 6 months old, following maternal COVID-19 vaccination during pregnancy or postpartum. Study Design: A prospective multicenter cohort study was...

https://www.nejm.org/doi/10.1056/NEJMoa2415879?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed   Key Findings: Classic Risk Factors: The five risk factors examined were hypertension, hyperlipidemia, underweight and overweight or obesity, diabetes, and smoking. These factors are estimated to account for about 50% of the global burden of cardiovascular disease. Li...

GLP1 might cause thyroid cancer in mice but the evidence is drastically lacking in humans Oral semaglutide is expensive for an NNT of 50 at 4 yrs Tiktok videos of skin care are a scam

https://jamanetwork.com/journals/jama/article-abstract/2834040 amiloride is realistically equal to spironolactone for resistant HTN https://journals.lww.com/ajg/abstract/2025/05000/higher_rate_of_spontaneous_bacterial_peritonitis.24.aspx prophalaxis antibiotics might not be needed https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2834317 If you got a friend in weight loss-- or...

https://www.jthjournal.org/article/S1538-7836(25)00109-6/fulltext Antithrombotic agents, like aspirin and anticoagulants, are essential for treating many cardiovascular conditions. However, a common side effect is bleeding, with extracranial bleeding—bleeding outside the brain and spinal cord—being quite prevalent. This study, a secondary analysis of the Aspirin in Reducing Events in the Elderly,...

https://jamanetwork.com/journals/jama/article-abstract/2834632 Summary The article examines the effectiveness and safety of zilebesiran, an RNA interference therapeutic agent, when used in combination with standard first-line antihypertensive drugs for patients with inadequately controlled hypertension. The phase 2, prospective, randomized, double-blinded trial was conducted over multiple internat...