The Daily Med

THE DAILY EDITIONTUESDAY, 3 NOVEMBER 2026

Case of the Day · Clinical Reasoning

Persistent ST elevation: choose reperfusion.

A 59-year-old has 70 minutes of persistent chest pressure. ECG shows ST elevation in II, III and aVF with reciprocal depression in I and aVL. He is haemodynamically stable, has no fibrinolysis contraindication, and the nearest PCI centre estimates first-medical-contact-to-device time at 150 minutes.

What is the most appropriate immediate reperfusion strategy?

Drug Corner

Pharmacology in practice

PROTON-PUMP INHIBITOR

Pantoprazole (oral)

Indication: Reflux oesophagitis and acid-related disorders.
Mechanism: Suppresses gastric acid by inhibiting parietal-cell H+/K+-ATPase.
Interactions: Acid suppression can impair absorption of pH-dependent medicines; check the product information for atazanavir and high-dose methotrexate.
Important adverse effect: Headache or diarrhoea; long-term use is associated with hypomagnesaemia.
Dosing: Reflux oesophagitis: 40 mg once daily, usually for 4 weeks; reassess if symptoms persist.
Sources: SmPC: https://www.medicines.org.uk/emc/product/449/smpc

Paper of the Day

Research, without the noise

Endocrinology · Diabetes

Continuous Glucose Monitoring in Non–Insulin-Treated Type 2 Diabetes

In a 26-week randomized trial in 22 US primary-care practices, adults with non-insulin-treated type 2 diabetes were assigned to continuous glucose monitoring (145) or routine monitoring (138). HbA1c fell by 1.6 versus 0.7 percentage points; adjusted between-group difference −0.9 (95% CI −1.1 to −0.6). Time in range was 21 percentage points higher (95% CI 16–26). The authors found improved glycaemic measures; the trial does not establish long-term complication benefit. Summary based on the published abstract.

Authors: T.K. Oser and Others

Published: 14 October 2026 · New England Journal of Medicine

DOI: 10.1056/NEJMoa2608571

Read the original paper →

Journal Watch

What's new in medicine?

Gastroenterology · Ulcerative colitis

Phase 2 Trial of Icotrokinra for Patients with Ulcerative Colitis

In a 252-person phase 2b RCT, week-12 clinical response was 63%, 58% and 55% with three oral doses versus 27% with placebo (all P<0.001); longer trials are needed to establish durability and safety.

Cardiac rehabilitation

Efficacy of Home-Based Telerehabilitation Versus Center-Based Cardiac Rehabilitation on Cardiopulmonary Function and Exercise Capacity in Patients After Coronary Artery Bypass Grafting: A Randomized Controlled Trial

In this 111-person randomized trial, both 12-week home telerehabilitation and centre-based rehabilitation improved peak oxygen uptake and 6-minute walk distance versus usual care, with no significant difference between the two programmes; 101 completed follow-up.

Oncology · Immune pneumonitis

Three versus six weeks of corticosteroids for mild immune-related pneumonitis: a randomized trial

In a 106-patient randomized trial, non-inferiority of a 3-week taper versus 6 weeks was not established for 8-week treatment success (66.7% vs 85.2%); relapse/exacerbation was more frequent with the shorter course.

Today's Topic

Build your clinical knowledge

Dermatology · Seborrheic dermatitis

Seborrheic dermatitis: control flares and maintain remission

Diagnosis / Testing

Typical disease causes erythema with greasy scale in sebaceous areas (scalp, face, ears and presternal chest). Diagnose clinically; reconsider psoriasis, rosacea or tinea when distribution or morphology is atypical.

Treatment / Care Decisions

Use topical antifungal therapy for scalp or facial disease; a short course of low-potency topical corticosteroid can control marked inflammation. Avoid prolonged facial steroid use; consider a calcineurin inhibitor for recurrent facial disease.

Risk Assessment / Prognosis / Epidemiology

The condition is chronic and relapsing. HIV infection, Parkinson disease and some neurologic illness are associated with more severe disease; investigate contextually rather than screening every patient.

Pathophysiology / Basic Science

Malassezia species and host inflammatory response contribute to disease; antifungal treatment reduces yeast burden, while anti-inflammatory treatment controls symptoms.

Further reading: American Family Physician (2025): Seborrheic Dermatitis—Diagnosis and Treatment.