Hyponatremia: Evolving diagnostics and emerging therapeutics in clinical practice  CCR Journal Watch criticalcarereviews.com/late…

Today's Paper of the Day is: What every Intensivist should know about ... Ammonia in liver failure criticalcarereviews.com/late… Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2026

Original Article: Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis at 10 Years (RECOVERY trial) nejm.org/doi/full/10.1056/NE… #Surgery #Cardiology

Mechanical Complications After Acute Myocardial Infarction: A Shock-Stage and Timing-Based Management Framework CCR Journal Watch criticalcarereviews.com/late…

PRO-TAVI trial: Deferring PCI was non-inferior to routine PCI before TAVI for the 1-year composite of all-cause mortality, MI, stroke, and major bleeding, suggesting its appropriate role in selected CAD patients. #ACC26 View slides here: clinicaltrialresults.org/wp-…

UFH-STEMI trial: In STEMI patients undergoing primary PCI, pretreatment with UFH 70-100 IU/kg at prehospital first medical contact improved infarct-related artery patency without increasing the risk of BARC types 3-5 bleeding. #ACC26 View slides here: clinicaltrialresults.org/wp-…

Presented at #ACC26: Among patients with unprotected left main coronary artery disease, intravascular ultrasonography–guided PCI did not result in a lower risk of ischemic events or death than angiography-guided PCI. Full OPTIMAL trial results: nejm.org/doi/full/10.1056/NE… Editorial: Seeing the Left Main Coronary Artery Clearly — Is IVUS Always Necessary? nejm.org/doi/full/10.1056/NE… @ACCinTouch

Presented at #ACC26: Among patients with a preserved ejection fraction at least 1 year after myocardial infarction, stopping beta-blockers was noninferior to continuing therapy with respect to major clinical outcomes. Full SMART-DECISION trial results: nejm.org/doi/full/10.1056/NE… @ACCinTouch

Must-read review on heart failure with reduced ejection fraction (HFrEF) in the latest issue of The Lancet sciencedirect.com/science/ar… @TheLancet

The future of #HFrEF treatment: can we move from a strategy of “Lifetime quadruple therapy for all” to “Personalized GDMT”? Congratulations to @UTSWMedCenter MS4 Michael Pitonak for leading this effort! @jtthib

Bayesian statistics for clinical research This review provides a brief account of the philosophical and methodological differences between Bayesian and frequentist approaches and survey the use of Bayesian methods for the design and analysis of clinical research. #Bayesian #bayestheorem #ClinicalTrial #Probabilities thelancet.com/journals/lance…

In patients with type 2 diabetes and atherosclerotic cardiovascular disease, tirzepatide was noninferior to dulaglutide with respect to major cardiovascular events. Full SURPASS-CVOT trial results: nej.md/4qd5rLx

25 World-Beating African “Institutions”, YES! (In No Particular Order) 1. The Springboks. South Africa: A rugby team that mastered trauma, tactics, and timing. Sometimes wins ugly. Wins far too often. 2. Visit Rwanda Kigali City: Radical rebranding turned into civic discipline. Cleanliness so enforced it feels constitutional. 3. Tangier Med Port. Morocco: Europe’s backyard reminder that Africa can run logistics at scale and on schedule. 4. Patrice Motsepe. South Africa: A one-man institution. Mining wealth turned into thoughtful philanthropy and continental football order. As CAF president, he stabilised finances, raised prize money, enforced governance, and made African football bankable again. 5. Kenya’s long-distance running culture: No ministry. No manifesto. Just altitude, discipline, and ruthless peer competition. 6. Ethiopia’s long-distance running culture: More monastic than Kenya’s. Less noise. Suffering as syllabus. 7. Afrobeats. Nigeria, exported globally: Beat visas, gatekeepers, and taste police. Lagos hacked the global playlist unapologetically. 8. Noor Ouarzazate Solar Complex. Morocco: Desert turned into electrons. Scale without apology. Climate ambition that actually plugs in. 9. Nigerian creative writing ecosystem. Nigeria: A brutal, brilliant informal university. Global literature fuelled by chaos, irony, and tight prose. 10. M-Pesa. Kenya: A financial disruption. Banks blinked. Copied everywhere in the worldl. Still ahead. 11. Mauritius International Financial Centre: A small island running big systems. Africa’s most credible, imaginatively regulated gateway for capital. 12. Timkat Festival. Ethiopia: Faith as mass choreography. No tickets. No influencers. World-class logistics, every year. 13. Egypt’s tourism civilisation stack.: Five thousand years on, still unbeatable IP. Everyone else is still marketing. 14. Uganda’s specialty coffee revival: An unsung revolution. From anonymous bulk to named origins and premium value. 15. Zeitz MOCAA and the Lagos art ecosystem. South Africa and Nigeria: One anchors African art globally. The other produces it relentlessly. 16. Institut Pasteur de Dakar. Senegal: African science that ships vaccines. Quiet competence. 17. Botswana’s diamond governance model: Resource wealth without national self-destruction. Boring. Disciplined. Rare. 18. Mauritius public administration: Courts that work. Tax codes that make sense. The state as service, not threat. 19. Ethiopian Airlines: A flag carrier that behaves like a ruthless business. Profitable, punctual, pan-African before it was fashionable. 20. South African jazz tradition: Music as archive and resistance. Marabi to Cape Jazz. Improvisation as history. 21. Marrakesh’s tourism machine. Morocco: Design, food, festivals, rhythm. Ruthlessly curated magic. 22. Nigeria’s startup ecosystem: Chaos as advantage. Speed as strategy. World-class ideas. 23. Lesotho Highlands Water Project: A mountain kingdom exporting water to South Africanindustrial giant. Infrastructure as leverage. 24. The Cotonou Voodoo Market. Benin: A unique ancient spiritual economy that still functions. Belief, commerce, and continuity. 25. African mothers. Pan-African: The most overworked, under-credited institution on the continent. Runs households, economies, morals, and futures. No bailouts. Still standing.

Rationale, Design, and Baseline Clinical Characteristics of the Ziltivekimab Cardiovascular Outcomes Trial Interleukin-6 Inhibition and Atherosclerotic Event Rate Reduction The ZEUS randomized clinical trial will formally test the hypothesis that IL-6 inhibition with ziltivekimab will lower incident cardiovascular event rates and potentially slow kidney decline among participants with known ASCVD, CKD, and elevated hsCRP #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @brendonneuen @goKDIGO @ERAkidney @mvaduganathan @JavedButler1 jamanetwork.com/journals/jam…

Original Article: A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia (SONIA trial) nej.md/47glh02 Editorial: Glucocorticoids for Pneumonia in Africa — Old Therapy, New Context nej.md/4qgjdxH #Pulmonology #CriticalCare

Effects of semaglutide in obesity-related heart failure with preserved ejection fraction across the age spectrum: Findings from the STEP-HFpEF programme In patients with HFpEF enrolled across the STEP-HFpEF and STEP-HFpEF DM trials, treatment with semaglutide improved disease-specific symptoms, physical function and reduced body weight across the age spectrum #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @DLBHATTMD @CMichaelGibson @SubodhVermaMD @mmamas1973 @DrMarthaGulati @hvanspall @AndrewJSauer @ankeetbhatt @hfcollaboratory @HFA_President @GMCRosano @biljana_parapid @AnastasiaSMihai @Hragy onlinelibrary.wiley.com/doi/…

🧵 Albumin in Critical Care: 70 Years, 700 Papers… Zero Benefit 1/ Albumin is the most studied fluid in critical care. Decades of trials. Endless meta-analyses. And yet – not a single clinically meaningful benefit. Here’s why the entire theory collapses once you understand Extended Starling. 👇

Among patients with early #septic shock, a personalized hemodynamic resuscitation protocol targeting capillary refill time was superior to usual care for the primary composite outcome, primarily driven by a lower duration of vital support. ja.ma/4pTtvmn

Big news: Results of the HIGHLY anticipated RSI trial: Ketamine vs Etomidate 🥁 Drumroll... n=2,365 pts 1° No difference in mortality (28.1 vs 29.1%) 2° Ketamine associated with WORSE hemodynamic outcomes (SBP <65, new/increased vasopressor requirement, or cardiac arrest): 17 vs 22% #CCRDownUnder

In the SONIA trial conducted in general medical wards with limited diagnostic and therapeutic resources in Kenya, glucocorticoids reduced mortality in patients with community-acquired pneumonia. Full trial results and Research Summary: nej.md/47glh02