Episode 421: 428. Asthma and Stroke --- A breathless combination
Questioning Medicine13 Mars

Episode 421: 428. Asthma and Stroke --- A breathless combination


Minocycline in Acute Ischemic Stroke (EMPHASIS trial)


A multicenter, double-blind RCT in China studied 1,724 patients with acute ischemic stroke treated within 72 hours of onset. Patients received either a 4.5-day course of oral minocycline or placebo. Minocycline works by inhibiting microglial activation, which contributes to post-stroke inflammation.


  • Primary outcome:     52.6% of minocycline patients vs. 47.4% of placebo patients achieved good functional recovery (mRS 0–1) at 90 days (p=0.0061).


  • Safety:     No difference in adverse events.


  • Practice impact:     Clinicians are cautiously optimistic; further positive trials could lead to selective use of minocycline in AIS patients.


2. Tenecteplase for Basilar Artery Stroke (TRACE-5 trial)


This phase 3 RCT in China tested IV tenecteplase given within 24 hours of ischemic basilar artery occlusion against standard medical care (both groups could undergo thrombectomy).


  • Results:     At 90 days, 38% of tenecteplase patients vs. 29% of controls had no or minimal disability (mRS 0–1 or baseline).


  • Safety:     Similar rates of intracranial hemorrhage (2–3%) and mortality (29–31%).


  • Practice impact:     Promising expansion of the thrombolytic window for severe posterior strokes; more evidence needed before routine use outside research settings.


Avsnitt(388)

Episode 394: 402. Cardiovascular Risk Factors, Zilebesiran, Shared Decision Making

Episode 394: 402. Cardiovascular Risk Factors, Zilebesiran, Shared Decision Making

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 hype...

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Episode 393: 404. 3 quick articles you might want to know about (oral semaglutide, tiktok, and GLP1 thyroid cancer)

Episode 393: 404. 3 quick articles you might want to know about (oral semaglutide, tiktok, and GLP1 thyroid cancer)

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

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Episode 392: 403. 3 Papers, 1 Podcast - One Guideline Changer

Episode 392: 403. 3 Papers, 1 Podcast - One Guideline Changer

https://jamanetwork.com/journals/jama/article-abstract/2834040amiloride is realistically equal to spironolactone for resistant HTNhttps://journals.lww.com/ajg/abstract/2025/05000/higher_rate_of_sponta...

16 Juni 202514min

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 Juni 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 Juni 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 Maj 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 Maj 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 Maj 20258min

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