The Clinical Chronicle

Welcome to Season 2, Episode 1 of The Clinical Chronicle.This episode delivers major practice-changing updates in medicine for 2026, including the new AHA and ASA acute ischemic stroke guideline, evolving evidence on sodium correction in severe hyponatremia, and why current lung cancer screening criteria may be missing more than 60 percent of patients at diagnosis.We break down expanded eligibility for endovascular thrombectomy in larger core strokes, the shift toward dual antiplatelet therapy over thrombolysis for minor nondisabling stroke, and updated blood pressure management recommendations in acute ischemic stroke. These changes are highly relevant for hospitalists, emergency physicians, neurologists, and internal medicine residents preparing for ABIM and ITE exams.We also examine new data challenging long-standing slow correction thresholds in severe hyponatremia. Observational findings suggest that medium or faster sodium correction may be associated with lower mortality and fewer neurologic complications compared with very slow correction, prompting reexamination of current guideline targets.In oncology and cardiometabolic medicine, we review:• Lung cancer screening data showing 64.9 percent of patients did not meet USPSTF criteria at diagnosis • An age-based low-dose CT screening model that could prevent more than 25,000 deaths annually • GLP-1 receptor agonists associated with a 54 percent reduction in mortality among colon cancer patients with obesity • Survivorship data revealing substantial risk of non-lung secondary malignancies after curative treatment for non-small cell lung cancerWe also discuss projected U.S. obesity prevalence reaching nearly 47 percent by 2035, with major implications for diabetes, cardiovascular disease, chronic kidney disease, and health system demand.In gastroenterology, real-world multicenter data demonstrate durable clinical, endoscopic, and histologic remission with upadacitinib in ulcerative colitis at one year.In neurology and environmental health, long-term air pollution exposure is linked to increased risk of motor neuron disease, including ALS, as well as faster functional decline and higher mortality.Additional updates include heavy lifetime alcohol use and colorectal cancer risk from PLCO trial data, and sex-specific response to varenicline in cannabis use disorder, where benefit was observed in men but not women.We also introduce a new recurring segment, Before You Order That Test, inspired by Choosing Wisely principles and focused on high-value care. This episode highlights a critical reminder: do not diagnose or manage asthma without spirometry.This podcast is designed for internal medicine residents, fellows, hospitalists, and attending physicians who want concise, clinically relevant updates across stroke, oncology, cardiometabolic disease, gastroenterology, preventive medicine, and public health.Be relentless. Save lives.

From blood-based diagnostics and durable disease-modifying therapy in Alzheimer’s disease to age-dependent cardiovascular protection with GLP-1 and SGLT2 therapies, this episode captures the most practice-changing advances of 2025. We unpack 10 high-impact updates, including expanded SGLT2 use across the full spectrum of chronic kidney disease, CDC-endorsed twice-yearly injectable HIV prevention, phenotype-driven biologics in COPD, and long-awaited survival gains in small cell lung cancer redefining frontline and relapsed care. Together, these shifts signal a decisive move toward earlier intervention, precision treatment, and trajectory-altering outcomes across major disease states.

From targeted therapies in HER2-mutant lung cancer to the latest Alzheimer’s data with Kisunla, this month’s breakthroughs could reshape patient care. We unpack 10 high-impact studies and trials, including new insights on ILD–cancer links, the HOPE trial in late-window stroke thrombolysis, phenotype-specific benefits of CPAP, and kidney-protective strategies in diabetic CKD. Designed for clinicians, this deep dive blends the latest evidence with real-world clinical implications.

From a once-monthly GLP-1/GIP driving 16% weight loss to a twice-yearly HIV PrEP injection, this episode unpacks the most practice-changing updates in internal medicine. We cover new evidence in obesity care, MASH reversal, stroke anticoagulation timing, sarcoidosis management, COPD biologics, and the cardioprotective power of oral semaglutide. Plus, hear what every rising PGY-2 should know heading into senior year.

From FIT screening outpacing colonoscopy in participation to anti-CD20 drugs showing lasting MS control at 7+ years, this edition brings clarity to complex clinical choices. We examine how metabolic syndrome increases young-onset dementia risk by 24%, why post-ERCP pancreatitis rates haven’t budged in two decades, and the unchanged survival edge between IO and IV access in cardiac arrest.As phthalates in plastics are linked to 350,000 heart deaths and cannabis use raises dementia odds, we separate correlation from causation. Meanwhile, fecal therapy via colonoscopy proves safe and 95% effective for recurrent C. diff, and FDA expands TAVR for asymptomatic aortic stenosis with a 50% lower risk of death, stroke, or hospitalization.