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I'm Dr. Joseph Kumka, Gastroenterology Fellow, educator, and creator of this podcasts. Whether you're a resident gearing up for the boards, a fellow diving deep into subspecialty topics, or a practicing clinician hungry for high-yield updatesβ€”you’re in the right place. Subscribe, engage, and let's raise the bar together.
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"Got Knowledge Doc" Podkast with Dr. RR Baliga The "Got Knowledge Doc" Podkast, hosted by Dr. Ragavendra R. Baliga, is a knowledge-driven platform designed for physicians and healthcare providers seeking to stay at the forefront of medical science and innovation. With a distinguished career in cardiovascular medicine and academic leadership, Dr. Baliga engages with leading experts to explore cutting-edge research, emerging technologies, and transformative insights in medicine and beyond. Eac ...
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A joint project of Costs of Care and the ABIM Foundation, the Teaching Value in Health Care Learning Network is a dynamic community of medical residents, students, faculty and others who are committed to learning and teaching the principles of stewardship and high-value care. Our podcasts include conversations with leaders and innovators who are implementing successful tools and strategies in their organizations.
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The California Work Comp Report is a podcast for California workers' compensation professionals and injured workers. In a series of interviews with Dr. John Alchemy, physicians, QMEs, and other industry experts, all aspects of California workers' compensation are demystified. The series also covers current events related to workers’ compensation.
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🧬 Can we rejuvenate the aging immune system? A new Nature Aging trial suggests we might be closer than we thought. In 50 healthy adults aged 45–70, urolithin Aβ€”a mitophagy activatorβ€”improved immune fitness over just 28 days: βœ… ↑ naΓ―ve CD8⁺ T cells βœ… ↓ exhaustion markers (TOX) βœ… ↑ mitochondrial biogenesis (PGC-1Ξ±) βœ… ↑ fatty-acid oxidation capacity βœ…β€¦
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πŸ«€ Personalizing DAPT: When "One Size Fits All" Fails πŸ•ŠοΈπŸ’Š The HOST-BR trial in The Lancet offers an important clinical lesson: Bleeding risk should guide antiplatelet duration after PCI β€” not habit, not inertia. πŸ” Key insight In ARC-HBR patients, 1-month DAPT was not non-inferior to 3 months In non-HBR patients, 3-month DAPT was non-inferior to 12 m…
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🚨 New Pharmacotherapy for Obstructive Sleep Apnoea πŸŒ™πŸ’Š In a landmark Phase 2 trial published in The Lancet, sultiameβ€” a carbonic anhydrase inhibitorβ€”showed dose-dependent reduction in AHI and improved nocturnal oxygenation in adults with moderate–severe OSA. πŸ’‘ Key insights: β€’ 298 participants across 5 European countries β€’ 200 mg daily delivered the …
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πŸ“’ New Study Alert πŸ©ΊπŸ’Š In JAMA Internal Medicine, a national analysis reveals that using the PREVENT risk calculator (vs Pooled Cohort Equations) dramatically reduces the number of U.S. adults aged 40–59 eligible for aspirin in primary prevention of cardiovascular disease. Among 7.6 million current aspirin users, >96% wouldn't qualify by PREVENT 🀯. T…
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🧠 TACSI Trial in NEJM (Sep 2025) challenges the status quo on dual antiplatelet therapy after CABG for ACS! πŸ‘¨β€βš•οΈ 2201 patients across 5 Nordic countries πŸ’Š Ticagrelor + Aspirin β‰  better outcomes vs Aspirin alone πŸ“‰ No reduction in death, MI, stroke, or revascularization 🩸 But bleeding (4.9% vs 2.0%) & dyspnea (18.2% vs 6.4%) increased πŸ“š Guidelines ma…
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πŸ§ͺ NEO-MINDSET Trial πŸ‡§πŸ‡· published in NEJM asks: Can we safely drop aspirin early after PCI in acute coronary syndromes (ACS)? πŸ’Š Monotherapy with ticagrelor/prasugrel reduced bleeding 🩸 but increased early ischemic events πŸ’₯ vs dual antiplatelet therapy (DAPT). ❗ Noninferiority for major adverse cardiovascular events was not met. πŸ” DAPT still stands t…
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🚨 New in NEJM β€” The ALASCCA Trial 🧬 Low-dose aspirin (160 mg/day) reduced colorectal cancer recurrence in patients with PIK3CA, PIK3R1, or PTEN mutations 🎯 βœ… 3-year recurrence: 7.7% (aspirin) vs 14–17% (placebo) βœ… Group A HR: 0.49 | Group B HR: 0.42 βœ… NNT as low as 6 in stage III rectal cancer πŸ’₯ ⚠️ Slight increase in adverse events 🧠 Editorial call…
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πŸ’‘ TARGET-FIRST trial (NEJM, Aug 2025) shows that in low-risk AMI patients post-PCI with complete revascularization, stopping aspirin after 1 month and continuing P2Y12 monotherapy is noninferior to dual antiplatelet therapyβ€”with 54% fewer bleeding events πŸ©ΈπŸ›‘πŸ’Š βš–οΈ A modern, patient-tailored antiplatelet strategyβ€”backed by potent P2Y12 inhibitors and s…
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πŸ’‘ "Cogito, ergo sum" β€” I think, therefore I am. RenΓ© Descartes laid the foundation of modern Western philosophy and scientific reasoning, linking algebra to geometry, and mind to body. πŸ§ πŸ“ His legacy reminds healthcare professionals to unite reason with compassion β€” science with soul. β€οΈβš•οΈBy MasterMedFacts LLC
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πŸ’ŠπŸ«€ Aspirin in the Crosshairs? The AQUATIC Trial (NEJM, Aug 2025) raises sharp questions on dual-pathway therapy in chronic coronary syndrome (CCS) patients already on long-term anticoagulation. πŸ“‰ Adding aspirin led to: β€’ ↑ Ischemic events (HR 1.53; P=0.02) β€’ ↑ Mortality (HR 1.72; P=0.01) β€’ ↑ Major bleeding (HR 3.35; P) 🧠 Takeaway: More isn't always…
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🧠πŸ’₯ Could lead poisoning have helped shape human evolution? A bold new hypothesis suggests that Homo sapiens may have survived while Neanderthals and Denisovans vanishedβ€”thanks to genetic defenses against environmental lead. 🧬 By analyzing fossil teeth 🦷 and testing brain organoids πŸ§ͺ, researchers found that ancient lead exposure disrupted key langua…
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🚨 New in Nature 🧬: Groundbreaking study reveals how HMGN1, a dosage-sensitive epigenetic regulator on chromosome 21, reprograms atrioventricular cardiomyocytes into a ventricular fateβ€”driving congenital heart defects in Down syndrome πŸ’”πŸ«€. Using hiPSCs, single-cell RNA sequencing, and a CRISPRa CROP-seq screen, researchers pinpoint HMGN1 as a causal …
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🚭 Lung Cancer in Nonsmokers – a hidden epidemic affecting up to 20% of global cases 🌍. Unlike tobacco-related disease, this form often strikes younger, female, and Asian populations, with EGFR and ALK mutations driving tumors πŸ”¬. Despite low mutation burden and no smoking history, these patients benefit immensely from targeted therapies like osimert…
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πŸ‘Ÿ Just 2 Days Can Make a Difference! πŸ§“πŸ“‰ In a large cohort of 13,547 older women (mean age 72), walking β‰₯4,000 steps/day on even 1–2 days/week was linked to a 26% lower mortality and 27% lower cardiovascular disease risk πŸ’₯. Those walking β‰₯3 days/week had even greater benefits! πŸ“‰ Higher step thresholds (up to 7,000/day) showed further mortality reduc…
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πŸ§“ Aging skin, fading flow. This 2025 Nature study uncovers how dermal capillary-associated macrophages (CAMs) decline with ageβ€”preceding microvascular dysfunction and impaired blood flow. 🧬 Using intravital imaging and macrophage fate mapping in mice (and validating in humans!), the authors reveal that CAMs are not replenished unless triggered by i…
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πŸ«€πŸ“‰ Published in The Lancet (Oct 22, 2025): SELECT trial investigators report that semaglutide reduced MACE by 20% in patients with obesity but without diabetesβ€”independent of weight loss. Waist circumference, not weight, tracked with outcomes, yet explained only 33% of the benefit. This landmark analysis redefines GLP-1RAs as disease-modifying agen…
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Hair Loss in Women" (The New England Journal of Medicine 2025; DOI 10.1056/NEJMcp2412146) πŸ“„, and it's a must‑listen for anyone in clinical practice or research. The piece highlights that female‑pattern hair loss increases with age and is closely tied to hormonal status, and that treatments span from topical 5% minoxidil or low‑dose oral minoxidil t…
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πŸ” New in The Lancet! A massive network meta-analysis of 94 RCTs (105,435 patients) reveals that antidepressants impact far more than mood πŸ§ β€”they alter weight βš–οΈ, glucose 🩸, BP πŸ’“, lipids 🧬, and liver enzymes πŸ§ͺ. Agomelatine πŸŒ™ may lower weight, while nortriptyline πŸ“ˆ raises heart rate. Time to rethink side-effect profiles when prescribing! πŸ“š Pills, Pre…
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🧬 Her Genes, His Risk, Our Mind πŸ’‘ New insights from Thomas et al., Nature Communications (2025) β€” summarized beautifully by Na Cai in Nature News & Views. Women carry a heavier polygenic burden for major depressive disorder (MDD), with ~6,000 female-specific variants and stronger genetic links to metabolic traits like BMI and metabolic syndrome. 🧠 …
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πŸ¦·πŸ«€ New Findings Linking Oral Health to Heart Attacks! 🧬🧫 Groundbreaking research in JAHA reveals that viridans streptococci, common oral bacteria, form biofilms in atherosclerotic plaques that evade immune detection. These stealthy invaders trigger innate and adaptive immune responses, correlating with plaque rupture, myocardial infarction, and sud…
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🧠 Why Does Alzheimer's Affect More Women Than Men? New insights from JAMA Medical News reveal that the answer goes far beyond longevity. 🌸 Biology, hormones, and even social factors intertwine β€” from estrogen decline and X chromosome genetics to APOE4 risks and underdiagnosis due to stronger verbal memory. Women make up two-thirds of all Alzheimer'…
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🚨 New Study Alert πŸ•’ Can when you eat improve how you feel? This open-label pilot study shows that Time-Restricted Eating (TRE) β€” limiting food intake to an 8–10 hour window β€” significantly improved: βœ… Quality of Life (↑ SF-36 & ↓ MAPS scores) βœ… Orthostatic Heart Rate (↓ by 11 bpm, p βœ… Mitochondrial ATP production (↑, p TRE may offer a safe, feasibl…
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🌟 Guru Nanak (1469–1539 CE): The Voice of Oneness & Compassion 🌟 From Ik Onkar (One God) to Seva (selfless service), Guru Nanak's message transcends faith β€” reminding us that true spirituality lies in equality, honesty, and compassion. πŸ•ŠοΈ His principles β€” Naam Japo (meditate), Kirat Karo (work honestly), Vand Shhako (share with others) β€” continue t…
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🚨 New Study Alert 🩺 Think you're low-risk? Think again. This MESA study shows that even "low-risk" individuals may harbor hidden coronary artery calcium (CAC) β€” and it matters. πŸ“ˆ Adding CAC scoring significantly improved ASCVD risk prediction, reclassifying up to 18% into statin-eligible groups. 🧠 Implication? Precision prevention may start with a …
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🧬 Cellular senescence is more than just a marker of aging β€” it's a key driver of ❀️ cardiovascular disease. From the p53/p21 and p16/Rb axes to mTOR, SIRT1/6, NF-ΞΊB, and ROS/DDR, these molecular pathways halt cell division, fuel inflammation πŸ”₯, and impair cardiac repair. Emerging data spotlight the roles of πŸ’£ SASP, πŸ§“ senescent MSCs, and 🎯 microRNAs…
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🚨 Hidden heart risks in plain sight? πŸ«€πŸ©» The latest AHA Scientific Statement unveils the power of opportunistic coronary artery calcium (CAC) detection on routine noncardiac chest CTs. With AI-driven automation, we can now detect subclinical atherosclerosis, improve preventive therapy, and bridge disparitiesβ€”all without additional imaging or cost. πŸ’‘β€¦
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🚨 Pickleball's Popularity Comes at a Price πŸŽΎπŸ‘οΈ As the fastest-growing sport in the U.S. hits 20M players, injuriesβ€”especially eye and orthopedicβ€”are rising sharply πŸ“ˆ. New data from JAMA Ophthalmology and JAMA News & Analysis reveal alarming trends: retinal detachments, fractures, falls, and moreβ€”mostly in players over 50 πŸ‘΅πŸ§“. Time to talk prevention…
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🧬 New insights from Nature Medicine! Researchers reveal that obesity caused by MC4R deficiency β€” the most common monogenic form β€” is paradoxically linked to lower LDL-cholesterol, triglycerides, and blood pressure πŸ’‘. Despite severe obesity, these individuals show a "metabolically healthier" profile, likely due to altered central melanocortin signal…
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🚼 Game-changer in the NICU! Same-day genome sequencing using Sequencing by Expansion (SBX) delivered actionable results in under 7 hours for critically ill infants 🧬⏱️. Two life-altering diagnosesβ€”including KCNQ2-related epilepsyβ€”were identified faster than any existing rapid test. Published in The New England Journal of Medicine πŸ“°. Precision care,…
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🩺 Desi Hearts, Hidden Plaques, Bold Truths πŸ’“πŸ«€πŸ“Š In the Atherosclerosis journal, Manubolu et al. use AI-powered CCTA to expose an alarming reality: 🧬 Young South Asians have high-risk plaqueβ€”even when CAC = 0. πŸ“‰ Risk scores fail to capture this. πŸ“Έ CCTA sees what traditional tools miss. It's time to personalize prevention for Desi hearts. #CCTA #DesiH…
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Microplastics β€” once dismissed as environmental debris β€” are now being found in the brain, placenta, heart, and bloodstream. πŸ§ πŸ«€πŸ‘Ά Recent JAMA (2025) and NEJM (2024) studies link them to inflammation, oxidative stress, and higher cardiovascular risk. ⚠️ From beer to baby bottles, no corner of modern life is untouched. 🍺🍼 It's time for urgent global a…
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πŸ”¬ New paradigm for HFpEF! 🧠 The Adipokine Hypothesis reframes preserved EF heart failure as an endocrine disorder driven by dysfunctional visceral fat. πŸ«€ Adipokines like leptin, aldosterone & neprilysin disrupt volume, inflammation & fibrosis. Target the fat ➑️ fix the heart! πŸ’‘ πŸ“„ JACC 2025 | Milton Packer MD #HFpEF #Cardiology #Adipokines #Visceral…
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🧠 New study in Nature Medicine links shingles (herpes zoster) to increased dementia risk β€” but there's hope! πŸ’‰ Adults β‰₯50 who received zoster vaccines (ZVL or RZV) had significantly lower dementia rates πŸ“‰. Especially protective in older women πŸ‘΅. Evidence mounts for VZV reactivation as a modifiable risk factor for neurodegeneration πŸ§¬πŸ›‘οΈ. πŸ“š Read more:…
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🚨 Real-World vs RCT? Only 1 in 3 patients with AMI-related cardiogenic shock in Japan met the πŸ”¬ DanGer trial criteria for Impella use. The J-PVAD registry (πŸ‡―πŸ‡΅, n=3975) reveals a stark βš–οΈ reality: eligibility matters, and survival varies! πŸ«€ Time to align practice with precision. πŸ“– Read the full European Heart Journal study for clinical pearls and ca…
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🚨 New Era in Medicine! πŸ©ΊπŸ€– JAMA Internal Medicine highlights how Generative AI (GenAI) is reshaping clinical workflowsβ€”from AI scribes πŸ“ to diagnostic copilots 🧠. Physicians must prompt wisely, partner smartly, and practice responsibly. A must-read to stay ahead! πŸ’‘πŸ“ˆ #GenerativeAI #DigitalHealth #MedicalEducation #JAMA πŸ”— https://jamanetwork.com/journ…
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🧠✨ New Science Perspective unpacks a "tripartite alliance" between TH17 cells, IL-22 cytokine signaling, and enterocytes in regulating fat absorption! πŸ₯‘πŸ§« Loss of Aster-A in T cells boosts IL-22, suppressing intestinal lipid uptakeβ€”a striking example of immune-metabolic crosstalk with implications for obesity and malabsorption. πŸ”¬πŸ›‘οΈ πŸ“˜ Science, Oct 20…
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🌸 Tulsidas (1511–1623 CE): India's Poet of Devotion and Duty ✨ Bridging East and West, Tulsidas transformed spiritual thought much like Dante, Milton, and Luther did in Europe. His Ramcharitmanas made divine wisdom accessible to all, blending poetry, psychology, and ethics. 🌏 A timeless voice for compassion, virtue, and inner transformation β€” remin…
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Clostridioides difficile Infection (CDI) Treatment Protocol 1.0 Purpose and Scope This protocol establishes a standardized, evidence-based framework for the diagnosis and management of Clostridioides difficile infection (CDI). Its strategic importance lies in unifying our clinical approach to improve patient outcomes, reduce the incidence of recurr…
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πŸ§¬πŸ’Š How long is too long to wait on statins? Two new studies reveal a powerful truth: ⏳ It's not just how high your LDL isβ€”but how long you've had it. πŸ”» Delayed statin initiation (⏰ >6 months) after detecting high LDL-C is linked with increased risk of MI and stroke. πŸ“† Enter "Cholesterol-Years"β€”a concept akin to pack-years for smoking: the longer th…
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🧬 New Era in Blood-Based Biomarkers! 🩸 A pan-disease atlas of the circulating proteome across 59 diseases and 8,262 individuals reveals powerful insights into age, sex, BMI, and disease-specific protein signatures. πŸ’‘ Highlights: πŸ”Ή Over 5,400 proteins profiled using Olink πŸ”Ή Longitudinal stability of wellness proteome πŸ”Ή Machine learning predicts biol…
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πŸ“£ New in NEJM: Ultraprocessed Food on an Ultrafast Track πŸ₯«βš‘️ Are ultraprocessed foods (UPFs) really the villains of modern nutrition? πŸ€” This thought-provoking piece critiques the Nova classification system πŸ§‚πŸ“Š and urges caution before reshaping national dietary policy around it. From 🍟 glycemic spikes to πŸ§ͺ questionable additives, the debate is rich …
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πŸ«€ New insights from EUROMACS registry! The latest JACC study explores the delicate βš–οΈ trade-off between bleeding 🩸 and ischemic 🧠 events in LVAD patients. While HM3 reduces thrombotic risks, bleeding remains the dominant threat. Time to rethink the "one-size-fits-all" anticoagulation πŸ§ͺ. Personalized strategies like LD-DOACs & lower INR targets may …
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🧬 New NEJM Review Alert! MGUS β€” once "undetermined," now clinically significant. This comprehensive update by Rajkumar & Kumar reveals how asymptomatic plasma clones may drive renal (MGRS) and neurologic (MGNS) damage 🧠🩺 even without cancer. πŸ”¬ Dive into new diagnostic pathways, risk models (iSTOPMM), and why "watch and wait" no longer fits for all.…
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🚨 New NEJM Study Alert! πŸ§¬πŸ’Š Baxdrostat, a selective aldosterone synthase inhibitor, shows significant BP reduction in patients with resistant & uncontrolled hypertension despite RAAS blockade and diuretic therapy. βœ… SBP ↓ ~9–10 mmHg at 12 weeks πŸ§‚ Targets salt-retaining physiology βš–οΈ Well-tolerated: early mild hyperkalemia & hyponatremia πŸ” Durable ef…
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🚨 New insights from the SCD-PROTECT Study! πŸ«€ In a nationwide German cohort of 19,598 patients with newly diagnosed NICM or MI/CAD, early use of the Wearable Cardioverter-Defibrillator (WCD) offered critical protection during the high-risk window of guideline-directed therapy initiation. πŸ“‰ Most shocks occurred in the first 200 days πŸ“ˆ >50% improved L…
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πŸ“’ New JAMA Review Alert! πŸ¦‹ Hypothyroidism remains a silent disruptor of health β€” often underrecognized, yet linked with fatigue 😴, weight gain βš–οΈ, cardiovascular disease ❀️, and reproductive health challenges 🀰. This latest JAMA clinical review underscores: βœ… Autoimmunity (Hashimoto thyroiditis) as the leading cause βœ… Lifelong levothyroxine πŸ’Š as fi…
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πŸšΆβ€β™€οΈπŸƒβ€β™‚οΈβ±οΈ Not all movement minutes are created equal! A major Nature Communications study using data from 73,000+ UK Biobank participants wearing accelerometers found: 1 minute of vigorous activity (VPA) = up to 9 mins moderate (MPA) or 94+ mins light (LPA) for reducing mortality, CVD, diabetes, and cancer risk. This rewrites the old 1:2 rule and …
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Hidden Horns 🐏, Silent Signals ⚑, New Memories 🧠 A new Science review reframes the hippocampus beyond the classic trisynaptic loop. Once-overlooked regions like CA2, fasciola cinereum, and indusium griseum β€” along with enigmatic signals such as small irregular activity (SIA) and dentate spikes (DS) β€” emerge as crucial for social memory, novelty det…
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🚨 Just read the latest Lancet 2025 Seminar on Large-Vessel Vasculitis – a must-read for anyone tracking πŸ” Giant Cell Arteritis, πŸ’₯ Takayasu Arteritis, and 🧬 Isolated Aortitis. From πŸš‘ clinical phenotypes to 🧠 imaging advances and 🎯 targeted biologics like tocilizumab and JAK inhibitors, this article bridges inflammation with innovation. πŸ“Έ Vascular im…
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🍬 Can sweeteners help you stay slim? A new 1-year multicenter RCT in Nature Metabolism shows that replacing sugar with sweeteners & sweetness enhancers supports modest weight loss maintenance βš–οΈ and beneficial gut microbiota shifts πŸ¦ β€”with no adverse cardiometabolic effects πŸ’“. 🚫 Less sugar, βœ”οΈ better weight control, 🧬 smarter microbiota. The future …
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