The double-blind, randomized phase III EMPEROR-Preserved trial showed a benefit of the sodium-glucose cotransporter-2 (SGLT2) inhibitor empagliflozin in patients with heart failure with preserved ejection fraction (HFpEF).
Now let us dig a bit more into those headlines.

 

Heart Failure with Preserved Ejection Fraction (Diastolic CHF) and SGLT-2 Inhibitor Therapy

An important recently published randomized control trial provides guidance on this controversy.

Should You Postpone Interventions for INFECTED Necrotizing Pancreatitis?

Spontaneous Bacterial Peritonitis - Unique Infections in Cirrhosis part 2

Unique Infectious Considerations in Cirrhosis - part 1

Can we trust a nuclear study to nail the diagnosis? Are motor abnormalities really the cause of symptoms? What is a POP procedure? 

Gastric Emptying Abnormalities - Part 2

Almost nobody feels comfortable managing DELAYED gastric emptying (gastroparesis) and very few medical providers even think about RAPID gastric emptying in their diabetic patients. Even if you send these patients to GI specialists, your blood sugar co-management of these patients can be heavily impacted by these issues. Is delayed gastric emptying always a bad thing? When your patient has upper GI symptoms, how often is it a gastric emptying abnormality? Time for some answers.

Diabetic Gastric Emptying Abnormalities (and sometimes normal) - Part 1

Does regular, low-dose, oral sustained-release morphine improve disease-specific health status or cause respiratory adverse effects in patients with moderate to very severe chronic breathlessness due to advanced chronic obstructive pulmonary disease? Digging in on the latest study.

Morphine for later stage COPD patients not on hospice

My take on what went down at the Journal of the American Medical Association. I disagree with the comment there isn't "structural racism in health care", but was the backlash against the Editor who didn't say it (and actually opposed the comment) an over-reaction? Can we have discussions about the controversial issues that affect healthcare (like gun violence or abortion) without cancel culture cancelling the people who want to have nuanced discussions? I fear we lost the ability to have dialogue in a field where every MD/DO/PA/NP by definition has an advanced degree - and therefore we should be able to dispute misinformed statements to bring about change without the outrage going so far as to fire a person who actually objected to the hurtful statement. 

The JAMA controversy and loss of conversation in medicine

Cows Milk - Healthy or Not?

Psilocybin Mushrooms - will they become an accepted medicine?

This lecture provides a basic understanding of how epigenetic changes influence infections/sepsis, vaccinations, cancer, future generations, your muscles, and (of course) those sweet tan-lines you are rocking.
Every day you are living through epigenetic changes that have huge implications on your health and who you are.

Understand Basic Epigenetic Changes in Medicine and Everyday Life

Hyponatremia remains a challenging topic for many because they are trying to memorize algorithms and numbers. You can usually nail the etiology by history & physical and a brief chart review. 

Hyponatremia etiology by history and physical

If you use the term 'cytokine storm' and don't really know what you mean by it, you are far from unique. Let me help to try and clarify it for you just a bit.

Cytokine Storm - part 1

Do you know what CRP is (other than saying it is an inflammatory marker)? Should we always shut down cytokines? If so, how? Why should we avoid giving a glucocorticoid to a COVID patient before they develop an elevated CRP or hypoxia? So many questions! A few answers are provided. 

Cytokine Storm - part 2

The Most Important Person That Lived For Our Health and Wellbeing

An (old) New Weapon to Fight Leg Cellulitis

Did you know systolic and diastolic blood pressure are NOT measured by automated BP cuffs? PRES (Posterior Reversible Encephalopathy Syndrome), also known as RPLS (Reversible Posterior Leukoencephalopathy Syndrome), is something you should recognize when you see it. Brief mentions of esmolol, nitroprusside, and other topics are scattered somewhere in between musings.  

Acute Severe Hypertension - part 4

Did you know that intravenous labetalol and oral labetalol are not really similar? The great hydralazine debate. Things you must know about Clevidipine if you are going to use it.

Acute Severe Hypertension - part 3

Acute Severe Hypertension - part 1

Multiple treatment issues are discussed. This includes theoretical ideal blood pressure lowering rates, oral options (for hypertensive urgency and specific populations), intravenous options (for hypertensive emergency or NPO patients), specific issues with aortic dissection, coronary syndromes, acute pulmonary edema & heart failure, labetalol, esmolol, nitroglycerin, and nitroprusside.

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