Staying #Up2Date 🚨

1. SBP targets 🎯

A Chinese study published in the Lancet involving 11,000 high-risk patients, including those with diabetes and previous stroke, found that an SBP target of <120 mm Hg resulted in fewer composite CV outcomes compared to <140 mm Hg (9.7% vs. 11.1%). That being said, there were more episodes of syncope in the intensive-treatment group. These results may echo the SPRINT trial, however, questions over generalizability and SBP targets remain. 

2. Hyperkalemia in diabetes 💊

A retrospective analysis compared approximately 400,000 propensity-matched pairs of patients with type 2 diabetes starting SGLT-2 inhibitors, GLP-1 receptor agonists, or DPP-4 inhibitors. Patients starting SGLT-2 inhibitors or GLP-1 receptor agonists had a lower rate of hyperkalemia compared to those starting DPP-4 inhibitors (HR 0.75 and 0.79, respectively). The absolute difference in hyperkalemia rates was about 6 fewer cases per 1,000 person-years for both drug classes, with greater reductions observed in patients with heart failure, CKD, or using RAAS inhibitors. 

3. MI from influenza 🦠

A Dutch observational study found that the incidence of acute MI was 6x higher within the first week after PCR-positive influenza (the risk period) compared to within 1 year before or after influenza, (excluding the risk period). Patients without known coronary artery disease (CAD) had even greater risk: relative incidences were 16.6 in those without CAD vs. 1.4 in those with CAD. In post hoc analysis, use of antithrombotics was associated with lower risk for MI than was nonuse (relative incidence, 4.1 vs. 13.5).

(Pfizer’s Version)

Pfizer throws their hat in the running for new gene therapy to help treat hemophilia A.

What happened: Pfizer’s experimental gene therapy for a rare genetic blood clotting disorder, hemophilia, succeeded in a large late state trial, paving the way for potential FDA approval.

Why it’s interesting: Pfizer is one of many drugmakers who have invested in the growing field of gene and cell therapies. Some health experts have said the one time treatment, which works by targeting a patient’s genetic cell to cure or alter the course of the disease, could replace traditional lifelong treatments.

Hemophilia affects roughly 25 in every 100,000 male births worldwide. Pfizer’s one time treatment significantly cut the number of annual bleeding episodes in patients with moderate to severe hemophilia A after 15 months. The drug also performed better than the standard treatment for the disease (routine infusions that replace the Factor VIII protein).

But: If approved, Pfizer will have to compete with BioMarin Pharmaceutical’s one-time treatment Roctavian, which was approved by the FDA last year. Since its release Roctavian‘s rollout has been slow which raises the question on whether or not patients will use Pfizer’s version if it enters the market.

While Pfizer has not released any information on possible side effects of their gene therapy, outside research has been conducted and in some cases patients have experienced vomiting, fever, myalgia, and increased liver enzymes after being treated.

What’s next: If you’re wondering about the next steps of the trial, Pfizer said they will hold medical meetings to give the public more information on their progress.

Sponsored by The Charting Coach

#StopTheHate (of your clinic days)

Clinic days are hard, there's never enough time to get everything done, and it’s commonly spilling over into our evenings and weekends.

That’s why Postcall is excited to offer you exclusive FREE access to a virtual workshop, "Stop Hating Clinic, Practical Strategies to Improve Your Clinical Day Experience," on July 27th at 11 am MT / 1pm ET with Dr. Sarah Smith, Founder of the Charting Champions Program for Physicians.

Despite your lack of staff, increasing patient demand, and inadequate admin time — you can create a clinical day that is more sustainable.

We will cover workflow, in-baskets, interruptions, patient demands, documentation, decision fatigue, and leave time for discussion and questions.

It is possible to see patients in the clinic and complete the tasks of the day with less expletives and less personal suffering.

Use Coupon Code CLINICBLUES to reserve your free seat today and share with a colleague.

Hot Off The Press

1: ❤️‍🩹 An HIV patient is in remission after a stem cell transplant — one of 7 people who have gone into remission from HIV between 2007 and 2023. The German man had undergone chemotherapy to wipe out his immune cells, and his stem cell donor was partially resistant to HIV. Only a few people are eligible for this treatment, as they must have both HIV and cancer.

2: 🫀 A team at Massachusetts General Hospital are pioneering techniques to make more hearts viable for transplant using advanced organ perfusion technology. The Ex Vivo system, also know as the "heart in a box" system, reanimates hearts by oxygenating and pumping blood through them, extending how long they can be kept outside the body.

3: 🇺🇸 US President Biden’s historical achievements — including allowing Medicare to negotiate prescription drug prices and dramatically expanding health coverage — is fragile and could be undone by future administrations. Kamala Harris — who Biden has endorsed, now that he’s dropped out from the race — would likely maintain his legacy, as she’s even further to the left on health care.

4: 🐍 Scientists have discovered a promising antidote candidate for cobra bites: heparin (the common inexpensive blood thinner). They found that by flooding the bite site with decoy heparin, the antidote can bind to and neutralize the toxins within the venom that cause tissue damage

5: 🍖 Two people have died due to a listeria outbreak after eating deli meat. The CDC hasn’t mandated a food recall yet because it remains unclear what specific foods have been contaminated with the disease. An outbreak has spread through 12 states and officials are asking people who are pregnant and the elderly to avoid eating from the deli counter.

Notable Numbers 🔢

343,000: the number of babies included in a study that concluded there is no significant risk of birth defects when women get COVID-19 vaccine in their first trimester.

78: the number of years it took a 103-year-old WWII veteran to get his benefits from the US government. The man worked as an army medical technician and said that although he received his card from the Veteran Administration, he didn’t realize he could use it to pay for things like health care!

2,400: the number of patients in Oregon who may have been exposed to infections due to a physician breaking protocol. The infections include Hepatitis B and C, as well as HIV. The physician has since been suspended.

Laugh Of The Day

@die_opbros

don't understand his problem #hospital #nurse #nurselife #operation #outpatient

The five second rule doesn’t apply here

Postcall Picks ✅

📺️ Watch: the 2024 Summer Olympic Games starting this week! Opening ceremony is on Friday, but the first official events actually start today. Here’s Team USA on the basketball court in a warmup showcase:

😂 Laugh: We’re looking at you ophtho 👀

🧠 Learn: Thinking about investing in a rental property? Here’s the 5 rules, according to the latest White Coat Investor podcast.

🔍 Check out: This post of yet another Simpson’s prediction. Will they ever end!?

Relax

First question: What is an anti-folate medication often used in rheumatoid arthritis?

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