Byrne NJ, Soni S, Takahara S, et al. Chronically Elevating Circulating Ketones Can Reduce Cardiac Inflammation and Blunt the Development of Heart Failure. Circ Heart Fail. 2020;13(6):e006573. doi:10.1161/CIRCHEARTFAILURE.119.006573
Fasting for Chemotherapy Induced Heart Failure?
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
Release Date: 03/20/2024
Great Doctors Series: 🦠 Fracastoro, Fomites & the Seeds of Contagion
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🦠 Before Germ Theory: Fracastoro, Fomites & the Seeds of Contagion In 1546—centuries before microbes could be seen—Girolamo Fracastoro proposed that epidemic diseases spread through transferable “seeds” or “spores”: by direct contact, contaminated objects, or even at a distance. 🔬 He introduced fomes, the root of our modern term fomite, and his poem Syphilis gave the disease its enduring name. 📜 A physician, poet & Renaissance polymath whose great insight was simple: contagion follows physical pathways that can be studied. 🧠 🎙️ Great Doctors Series |...
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🧠 Orexin Awakens: Sleep, Science & Serendipity
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🧠 From Discovery to Lasker to Drug Therapy! In 1998, Emmanuel Mignot and Masashi Yanagisawa helped launch discoveries that transformed our understanding of orexin and narcolepsy—work now recognized with the 2026 Albert Lasker Award for Basic Medical Research. 🏆 The translational arc is remarkable: 🔬 orexin deficiency → narcolepsy type 1 → diagnostic biomarker → mechanism-based therapy. Today, we can 🌙 block orexin signaling for insomnia or ☀️ activate OX2R to restore wakefulness in narcolepsy. A masterclass in how basic science changes medicine. 🎯 🎙️ Dr RR...
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🎭 Afib Ablation vs Sham: When Rhythm and Relief Part Ways
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🫀 Less AF—but not more relief? PVI-SHAM-AF delivers a provocative lesson. In symptomatic atrial fibrillation, catheter ablation substantially reduced AF detected on Holter, yet did not demonstrate superiority over sham for AF-related quality of life at 6 months. 🎭 💡 The clinical pearl: rhythm control and patient-perceived benefit are not interchangeable outcomes. A fascinating reminder that in procedural medicine, what the monitor records and what the patient feels may tell different stories. 🔬🫀 #AtrialFibrillation #Cardiology #Electrophysiology #MedEd
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🍞 Starch, Signals & Systemic Immunity: Not All Carbs Behave Alike
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🍞 Same calories—but very different immune signals. A randomized controlled feeding trial examined 44 adults after ~15% weight loss on a very-low-carbohydrate diet. Reintroducing refined starch activated immune and metabolic pathways, increased adipsin/complement signaling, and produced activation signatures across NK cells, monocytes, T cells, dendritic cells & neutrophils. 🧬🔥 💡 Take-home: Carbohydrate quality may matter as much as quantity when considering immunometabolic effects. ⚠️ Small, selected cohort; clinical consequences remain uncertain.
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🫀 The Infarct Ends. The Risk Doesn’t.
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🫀 The infarct ends. The risk doesn’t. After myocardial infarction, atherosclerosis, thrombosis, inflammation, depression, deconditioning—and declining adherence—can sustain risk for decades. Our editorial proposes Persistent Prevention: 🔄 reassess evolving risk, 🎯 treat residual risk, 💊 sustain therapy when indicated, 🏃 prioritize cardiac rehabilitation, and 🧠 address psychosocial health. The goal: move from a static discharge bundle to a dynamic, lifelong prevention plan. ❤️ #Cardiology #MyocardialInfarction #Prevention
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🫀 The Spleen–Heart Axis: Could the spleen hold a missing clue to coronary artery disease?
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🫀 Could the spleen hold a missing clue to coronary artery disease? Kamineni et al. used deep learning to extract 107 splenic MRI features in >42,000 UK Biobank participants. 🔬 Ten were associated with CAD, while genomics identified 219 loci—including the enigmatic 9p21 CAD locus. 🧬 The intriguing message: splenic texture—not simply size—may reflect a hematopoietic–inflammatory–genetic axis underlying CAD. ⚠️ External clinical replication was limited, so this is mechanistic discovery, not yet a clinical risk tool.
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🚨❤️ Pregnancy as a Cardiovascular Stress Test: A Window Into Lifelong Cardiovascular Health
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🤰❤️ Pregnancy may be one of our earliest cardiovascular stress tests. A Lancet editorial reminds us that cardiovascular disease complicates up to 15% of pregnancies and accounts for up to one-third of maternal deaths. Gestational hypertension predicts a 6× higher risk of later chronic hypertension, while pre-eclampsia is associated with up to a 3.5× higher risk of heart failure. 💡 The message for physicians: adverse pregnancy outcomes are cardiovascular warning signals—not endpoints. Think preconception ➡️ pregnancy ➡️ postpartum ➡️ lifelong prevention. 🫀
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Great Doctors Series: Pietro d’Abano⚕️ The Great Reconciler
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🔥 Medicine, Heresy & the Stars: Pietro d’Abano Meet Pietro d’Abano (c.1257–1315/16)—physician, philosopher, astrologer, and one of medieval medicine’s great intellectual boundary-crossers. 🩺📚 Drawing on Aristotle, Avicenna and Averroes, his Conciliator tried to reconcile medicine with natural philosophy. His willingness to question accepted explanations eventually collided with the Inquisition. ⚖️🔥 A fascinating reminder that medical progress has always depended on curiosity—and sometimes courage. 🎙️ Great Doctors Series | Where Curiosity Meets Clarity!
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🔥 Drop Aspirin? Not So Fast in High-Ischemic-Risk Patients
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🩸 Drop aspirin after 12 months? A-CLOSE says: not so fast. In 3,203 high-ischemic-risk patients after drug-eluting stenting, clopidogrel alone was noninferior to extended DAPT for net clinical events (5.0% vs 5.1%). But beneath that reassuring composite was a striking trade-off: ischemic events were higher with clopidogrel alone (3.7% vs 1.6%; HR 2.33), while bleeding was lower (1.8% vs 4.1%; HR 0.43). ⚖️ The lesson: “noninferior” does not mean clinically interchangeable. Individualize ischemic versus bleeding risk. ❤️
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💉 Lysis Before Collapse: PRAGUE-26 Changes the PE Conversation
Dr. RR Baliga's 'Podkast for the Kurious Doc'. Where Curiosity meets Clarity!
🫁 Stable—but not safe. Should we intervene before patients crash? PRAGUE-26 randomized 558 patients with intermediate-high–risk acute pulmonary embolism to catheter-directed low-dose alteplase + anticoagulation or anticoagulation alone. The 7-day composite of death, recurrent PE, or cardiorespiratory decompensation/collapse fell from 6.8% to 0.7% (RR 0.10; P<0.001)—mainly through fewer episodes of decompensation. 🎯 Major bleeding was not increased, although 2 intracranial hemorrhages occurred with thrombolysis. 🩸 💡 The emerging paradigm: prevent the crash rather than...
info_outlineFasting for Chemotherapy Induced Heart Failure?
Dr RR Baliga's 'Got Knowledge Doc' PodKasts for Physicians
de Groot S, Lugtenberg RT, Cohen D, et al. Fasting mimicking diet as an adjunct to neoadjuvant chemotherapy for breast cancer in the multicentre randomized phase 2 DIRECT trial. Nat Commun. 2020;11(1):3083. Published 2020 Jun 23. doi:10.1038/s41467-020-16138-3
Not Medical Advice or Opinion