Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have transformed the management of type 2 diabetes (T2D), obesity, and cardiometabolic disease by improving glycemic control, promoting clinically meaningful weight loss, and reducing major adverse cardiovascular events (MACE) in selected populations. Historically, GLP-1RA therapy has relied on injectable peptide agonists (e.g., liraglutide, semaglutide, dulaglutide, and exenatide), which mimic native incretin biology but require parenteral administration and cold-chain logistics. In parallel, oral GLP-1RAs have emerged through two distinct strategies: (1) the oral delivery of peptide agonists using absorption enhancers (e.g., oral semaglutide) and (2) true small-molecule, non-peptide GLP-1 receptor agonists (e.g., orforglipron), designed to be orally bioavailable without peptide constraints. This narrative review compares small-molecule oral GLP-1RAs to injectable peptide agonists across efficacy (glycated hemoglobin {HbA1c} lowering, weight reduction, and cardiometabolic outcomes), safety and tolerability (gastrointestinal {GI} adverse events, gallbladder disease, pancreatitis signals, retinopathy considerations, and rare hepatic signals), real-world adherence, and future innovation. Recent phase 3 evidence suggests that oral small-molecule GLP-1RAs can deliver glycemic and weight benefits approaching injectable standards, while high-dose oral peptide formulations may broaden oral options for obesity management. Remaining challenges include long-term outcome data, the optimization of titration to improve tolerability, and equitable access amid rapid market expansion.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors were developed as glucose-lowering agents, yet their clinical impact has expanded well beyond glycemic control. Although their benefits in heart failure and chronic kidney disease are now well established, a growing body of mechanistic and clinical evidence suggests broader utility in non-diabetic conditions such as nonalcoholic fatty liver disease (NAFLD), obesity and visceral adiposity, hypertension, hyperuricemia/gout, atrial fibrillation risk modulation, and select disorders of water balance (e.g., syndrome of inappropriate antidiuresis). These effects appear to arise from convergent pathways including natriuresis and osmotic diuresis, improved tubuloglomerular signaling, hemodynamic unloading, reductions in visceral fat and inflammation, alterations in urate handling, and shifts in substrate utilization with potential mitochondrial and endothelial benefits. This narrative review synthesizes emerging evidence for SGLT2 inhibitors in non-diabetic indications beyond heart failure and chronic kidney disease, with emphasis on biologic rationale, outcomes data, patient selection, safety in normoglycemic populations, and future research priorities.

Inflammatory myofibroblastic tumors (IMTs) are a group of soft tissue neoplasms with a predilection for the lungs and abdominopelvic cavity, characterized by a mixture of fasciitis-like, compact spindle cells, hypocellular fibrous histologic patterns, and distinctive molecular features. Due to their unspecified symptoms and non-specific radiologic presentation, the histopathologic and immunohistochemical analysis of a biopsy specimen is crucial for the diagnosis. We present a case of a 30-year-old man with intermittent hemoptysis diagnosed with a pulmonary IMT. We aim to review the literature regarding its definition, clinical findings, diagnosis, treatment, and prognosis. The treatment for an IMT is based on its location and extent, including complete surgical resection, which has a good prognosis compared to corticosteroids, chemotherapy, radiotherapy, and non-steroidal immunomodulation in patients who are not good surgical candidates. Further investigative studies with larger sample sizes and longer meticulous follow-ups are needed to demonstrate this neoplastic disease's natural history and find appropriate management for it.

Alzheimer’s dementia is a progressive neurodegenerative disorder in which cognitive decline, neuropsychiatric symptoms, and functional dependence emerge from a long preclinical and prodromal phase. Effective care increasingly requires an integrative approach: (1) disease-modifying pharmacology for selected patients early in the symptomatic course, (2) symptomatic pharmacotherapy for cognition and behavioral symptoms when benefits outweigh harms, and (3) non-pharmacological interventions that meaningfully affect quality of life, caregiver burden, safety, and functional outcomes across all stages. Recent advances, particularly anti-amyloid monoclonal antibodies, have reshaped early Alzheimer’s treatment while raising new implementation challenges around biomarker confirmation, monitoring for amyloid-related imaging abnormalities (ARIA), and health-system capacity. Evidence also supports structured non-pharmacological strategies (e.g., cognitive stimulation, physical activity, caregiver programs, and environmental and behavioral approaches for agitation) as core therapies rather than “adjuncts.” This narrative review synthesizes the evidence base and offers a practical, stage-based framework for combining pharmacological and non-pharmacological therapies, emphasizing person-centered goals, safety, feasibility, and equity.

Background: Acute kidney injury (AKI) is a common complication of COVID-19-associated acute respiratory distress syndrome (ARDS), yet the impact of extracorporeal membrane oxygenation (ECMO) on outcomes in this high-risk population remains unclear. Methods: We performed a retrospective, survey-weighted study using the National Inpatient Sample (NIS) database from 2020–2022 to compare outcomes among adults hospitalized with COVID-19-associated ARDS and AKI managed with invasive mechanical ventilation (IMV) alone versus IMV and ECMO. The primary outcome was in-hospital mortality, while secondary outcomes included renal replacement therapy (RRT), complications, hospital length of stay (LOS), and healthcare utilization. Results: Among 198,395 hospitalizations with COVID-19 ARDS complicated by AKI, 4730 received IMV and ECMO. ECMO use was not associated with statistically significantly lower adjusted in-hospital mortality (adjusted odds ratio [aOR] 0.96, 95% CI 0.81–1.12). However, ECMO was associated with greater odds of RRT, intracranial hemorrhage, disseminated intravascular coagulation, cardiogenic shock, vasopressor use, tracheostomy, acute liver failure, deep vein thrombosis, ischemic stroke and ICU-acquired weakness. ECMO was also associated with longer LOS and higher hospitalization charges. Conclusions: Among hospitalizations with COVID-19-associated ARDS and AKI, ECMO was not associated with statistically significantly lower adjusted in-hospital mortality but was associated with markedly higher complication burden, longer hospitalization, and substantially greater healthcare resource utilization.