Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Today, we're talking about Kawasaki disease-no, not the motorcycle company, though sometimes treating it does feel like trying to ride one at full speed through uncertainty.
For decades, high-dose aspirin was basically the holy water of Kawasaki treatment. Eighty to a hundred milligrams per kilogram per day-because apparently, kids with vasculitis also needed a little side of tinnitus. But here's the twist: new research says... maybe we didn't need all that aspirin after all.
Researchers at one hospital decided to mix things up. First, they treated 300 kids with the traditional high-dose aspirin. Then they switched the policy and gave the next 200 kids low-dose aspirin-3 to 5 mg/kg/day. Everyone got IVIG, because we're not completely reckless.

And the results? Drumroll please-no difference.

That's right. About 20% of kids in both groups needed IVIG a second time, and their coronary arteries looked... equally fine. The median max Z-score was 1.6 in both groups. (For the non-cardiologists out there, that's comfortably under aneurysm territory, which starts at 2.0.)

Basically, the low-dose kids did just as well-and none of them had to choke down near-toxic amounts of aspirin. So, high-dose: meet low benefit. Low-dose: meet my new best friend.

Jaksot(385)

Episode 391: 402. Functional disability after clinically significant extracranial bleeding: a secondary analysis of ASPREE

Episode 391: 402. Functional disability after clinically significant extracranial bleeding: a secondary analysis of ASPREE

https://www.jthjournal.org/article/S1538-7836(25)00109-6/fulltextAntithrombotic agents, like aspirin and anticoagulants, are essential for treating many cardiovascular conditions. However, a common si...

5 Kesä 20257min

Episode 390: 401. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

Episode 390: 401. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

https://jamanetwork.com/journals/jama/article-abstract/2834632SummaryThe article examines the effectiveness and safety of zilebesiran, an RNA interference therapeutic agent, when used in combination w...

4 Kesä 20258min

Episode 389: 400. CRP, Lipoprotein A, LDL for cardiac risk assessment

Episode 389: 400. CRP, Lipoprotein A, LDL for cardiac risk assessment

https://www.nejm.org/doi/full/10.1056/NEJMoa2405182?query=recirc_Semantic  Key Takeaways Extended Predictive Value of Biomarkers: High-sensitivity C-reactive protein (CRP), LDL cholesterol, and lipop...

29 Touko 20259min

Episode 388: 399. Use of albumin-adjusted calcium measurements in clinical practice

Episode 388: 399. Use of albumin-adjusted calcium measurements in clinical practice

Desgagnés N et al. Use of albumin-adjusted calcium measurements in clinical practice. JAMA Netw Open 2025 Jan 21; 8:e2455251. (https://doi.org/10.1001/jamanetworkopen.2024.55251)Overall, total calcium...

27 Touko 20257min

Episode 387: 398. Which is Better, Tirzepatide or Semaglutide?

Episode 387: 398. Which is Better, Tirzepatide or Semaglutide?

https://www.nejm.org/doi/10.1056/NEJMoa2416394At 72 weeks, the mean percentage decrease in weight was significantly greater with tirzepatide than with semaglutide (20% vs. 14%). Gastrointestinal side ...

21 Touko 20258min

Episode 386: 397. What is the new drug for smoking cessation?

Episode 386: 397. What is the new drug for smoking cessation?

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2832701In this multisite trial, 800 adults who smoked 10 or more cigarettes daily (mean duration of smoking, ≈35 years) were randomize...

9 Touko 20255min

Episode 385: 396. Vitamin D and Kids (CME)

Episode 385: 396. Vitamin D and Kids (CME)

What does the evidence and the guidelines say about the use and testing of Vitamin D in kids

7 Touko 20258min

Episode 384: 395. How accurate is the BMI?

Episode 384: 395. How accurate is the BMI?

Aryee EK et al. Prevalence of obesity with and without confirmation of excess adiposity among US adults. JAMA 2025 Apr 17; [e-pub]. (https://doi.org/10.1001/jama.2025.2704)The rate of obesity was 39.7...

6 Touko 20255min

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