Dr RR Baliga's "Got Knowledge Doc" Podkast

New Lancet Seminar on heart failure with reduced ejection fraction.  💓📘, this videocast walks listeners through the essentials of diagnosis, natriuretic peptides, imaging pathways, and the four foundational therapies shaping modern heart failure care. It's a clear, evidence-driven journey—designed to inform, clarify, and elevate bedside practice. Tune in to explore the science, the strategy, and...

🔍💓 Chronic Coronary Artery Disease: Seeing What Matters Before It Hurts   Just finished reviewing the 2025 Lancet paper on contemporary non-invasive imaging for chronic CAD, and the message is striking: how we see the heart shapes how well we save it.   From CT angiography that unmasks non-obstructive plaque 🖥️➡️🫀 to stress PET/CMR that maps true ischemia under load 💨📊, multimodality imaging...

Exploring David Hume 🧠✨ Just revisited David Hume's extraordinary contributions to modern thought — a reminder of how deeply empiricism, skepticism, and the science of human nature shape our intellectual world. His insights on causation, the limits of reason, and the power of moral sentiment continue to resonate across philosophy, psychology, economics, and evidence-based decision-making. 🌍📚 H...

The U.S. heart failure landscape is transforming—and fast. 🫀📊   A new JACC analysis reveals a 35-year shift from ischemic to metabolic drivers of heart failure, with obesity, dysglycemia, and chronic kidney disease rising sharply, even as blood pressure, cholesterol, smoking, and myocardial infarction decline. 📉⚖️   These trends demand a new generation of HF trials —more inclusive, prevention-f...

🧬⏳ New Insights into Organ-Specific Aging! 🧠❤️🩺   Just explored a remarkable Nature Aging study showing how organ-specific proteomic clocks can forecast disease, cognitive decline, and even longevity with impressive precision. These clocks—built from >2,900 plasma proteins—reveal that the brain, kidney, and arteries age on their own timelines , each carrying unique clues about future health.  ...

Respiratory vaccines are not just infection-fighters—they're cardiovascular protectors. 💉🫀 The 2025 JACC Consensus reminds us that influenza, pneumococcal, COVID-19, RSV, and zoster vaccines reduce MI, HF decompensation, hospitalizations, and death in our most vulnerable patients.   As clinicians, we hold the power to translate evidence into prevention: strong recommendations, simple pathways, a...

The latest JAMA article on keratinocyte carcinomas 🌞—a timely reminder that BCC and cSCC remain the world's most common cancers, with more than 5.4 million cases annually in the US alone . The review highlights essential updates in epidemiology, high-risk features, prevention, and evidence-based management, especially the role of sun protection, actinic keratosis treatment, and risk-stratified su...

🚨 Food Anaphylaxis: New Mechanisms Unveiled 🍽️🧬   A superb NEJM review highlights how cysteinyl leukotrienes act as gatekeepers in the gut—opening antigen passages, expanding mast cells, and amplifying the risk of oral anaphylaxis . The work elegantly bridges basic lipid biology with real-world food allergy challenges, and points toward new preventive strategies beyond current IgE-based therapie...

🌿 What does the evidence really say about medical cannabis? A new JAMA review highlights a clear message: cannabis helps few conditions—and harms may outweigh benefits for many. 📉 Small benefit for nausea ⚡ Moderate benefit for select pediatric seizures 💊 Limited evidence for pain, insomnia, or psychiatric use ❤️ Risks rise with high-potency products, especially for heart and mental health.  ...

Thrilled to see a major step forward in dengue prevention! 🦟💊 A new NEJM study reports that daily mosnodenvir , a first-in-class antiviral targeting the NS3–NS4B interaction , significantly reduced DENV-3 viral load and prevented infection in a controlled human challenge model. 📉🧬 It's early, but the results offer real hope for a long-awaited oral dengue prophylaxis —with encouraging safety, s...

  Delighted to share a concise update on the latest NEJM review of Long QT Syndrome 🫀📘 — a masterful synthesis by Schwartz & Crotti that reframes how we recognize risk, personalize therapy, and prevent sudden death in this genetically mediated disorder. The piece highlights ion-channel biology , gene-specific triggers , the impact of modifier genes , and the effectiveness of a tiered therapeutic...

🧠✨ Leibniz: Harmony, Logic, and the Birth of the Digital Mind   Celebrating Gottfried Wilhelm Leibniz — the mathematician-philosopher who co-created calculus , invented binary arithmetic , and envisioned a world stitched together by pre-established harmony . His Monadology reads like proto-systems theory, and his binary system is the quiet ancestor of every computer we use today.   For clinician...

🧬  New insights into autism : A 2025 JCI Viewpoint highlights how hundreds of genes , polygenic risk , and specific environmental factors converge during fetal brain development to shape autism likelihood. 🧠 Early biomarkers—from infant MRI and ERPs to machine-learning models using EHR data—are accelerating earlier, more tailored interventions. 🌱 Advances in gene therapy, IGF-1 pathways, and pr...

🔍 Peripheral Neuropathy: What Clinicians Should Know 🧠⚡   Peripheral neuropathy affects ~1% of adults worldwide, with diabetes accounting for more than half of all cases. The JAMA review highlights why length-dependent patterns dominate, how metabolic stress injures long axons first, and why sensory symptoms outpace motor loss. Evidence-based evaluation still begins with glucose testing, vitami...

New NEJM insights on asymptomatic carotid stenosis 🧠🔍   The CREST-2 trials offer a landmark update: intensive medical therapy remains the cornerstone , while carotid stenting shows selective benefit when performed by expert operators. Endarterectomy, however, provides no significant advantage over modern medical management.   With stricter blood-pressure and LDL targets, plus expanding use of PC...

The new Lancet Series on ultra-processed foods offers a striking insight: as UPFs rise globally, traditional whole-food diets decline—bringing nutrient imbalance, overeating, toxic exposures, and hyper-palatable formulations that quietly reshape health trajectories. 🍔➡️⚠️   Across more than 100 prospective studies and multiple trials, higher UPF intake consistently links to obesity, type 2 diabet...

Home-delivered DASH-patterned groceries paired with dietitian counseling meaningfully lowered blood pressure and LDL cholesterol among Black adults living in food deserts 🥗📉—as demonstrated in the GoFresh randomized trial (JAMA).   An accompanying editorial highlights why future "food-as-medicine" programs must prioritize underconsumed, health-promoting foods and align with modern evidence favor...

🩺 New insights in hemodialysis care. A major New England Journal of Medicine study reports that daily supplementation with long-chain omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) led to a 43% reduction in serious cardiovascular events among adults receiving maintenance hemodialysis. 🐟💙   In a population where traditional cardioprotective therapies often fall short, these...

🚀 A milestone moment in lipid therapeutics! The new JAMA trial on the oral PCSK9 inhibitor Enlicitide reports a ~60% reduction in LDL-C , with parallel decreases in ApoB and Lp(a) —all on top of maximally tolerated statin therapy.   For individuals with heterozygous familial hypercholesterolemia (HeFH) —where reaching LDL targets remains a persistent challenge—this represents a major advance. An...

☕ DECAF Trial insight! A new JAMA study shows that daily caffeinated coffee may lower recurrence of atrial fibrillation compared with abstinence. Patients drinking ~1 cup/day had 47% recurrence vs 64% with abstinence (HR 0.61, p=0.01) 📉💓 No major safety concerns—challenging long-held beliefs that coffee is proarrhythmic.   💡Takeaway: For many patients with AF, enjoying their morning brew may b...

🚨 New insights from The Lancet 🚨   A major individual-patient-data meta-analysis (6 RCTs, 8,836 patients) shows that complete revascularisation in acute myocardial infarction significantly reduces cardiovascular death, all-cause mortality, and recurrent MI. 💓📉   Benefits were consistent across age, sex, STEMI/NSTEMI , and lesion characteristics — strengthening the case for a more comprehensive...

🧬 New NEJM data on Olezarsen! In patients with severe hypertriglyceridemia , monthly RNA-targeted therapy delivered major triglyceride reductions (−62% to −72%) and a significant drop in acute pancreatitis risk (rate ratio 0.15).   ✨ Improvements extended to ApoC-III , remnant cholesterol , and non-HDL cholesterol , with consistent benefits across both CORE-TIMI trials.   💡 A promising step for...

📘 New Evidence from NEJM In a large meta-analysis of 17,801 patients with preserved LVEF after MI, beta-blockers did not reduce death, recurrent MI, or heart failure. Event rates were low, and outcomes were similar with or without therapy. 🫀📊   This clarifies practice for a growing post-MI population with LVEF ≥50%—precision matters more than tradition. 🎯   Full study: New England Journal of M...

📢 ADAPT AF-DES Trial — A Safer Path Forward! In patients with atrial fibrillation beyond 1 year after drug-eluting stent implantation, NOAC monotherapy delivered striking benefits over combination therapy. ✅ Lower net adverse clinical events ✅ Marked reduction in major/CRNM bleeding ✅ Similar ischemic protection A beautifully simple strategy with meaningful impact. Published in NEJM (2025) ....

🌊 OCEAN Trial offers fresh insight into antithrombotic therapy after successful AF ablation. In 1284 patients followed for 3 years, event rates were remarkably low 🌟. Rivaroxaban did not show superiority over aspirin for preventing stroke, systemic embolism, or covert embolic events, while bleeding risk was higher with anticoagulation.   🧠 96% had no new infarcts on MRI at follow-up.   Publishe...