New JAMA review attempts to equate pulmonary congestion with systemic congestion ("volume overload")
This is sloppy & often wrong
Pts w/ LV failure often have pulmonary congestion w/o systemic congestion
Pts w/ RV failure usually have systemic congestion w/ dry lungs
CVP isn't PCWP
#EMIMCC
So grateful to @shreyatrivedimd.bsky.social and Nick Villano for giving me this opportunity.
I am so happy and excited to be able to share information on a very important topic…an illness that impacts patients and caregivers alike. Day in, day out.
Please listen!
podcasts.apple.com/us/podcast/c...
Stupidity is a lack of intellectual capacity, an inability to learn. Ignorance is a state of not knowing, a state that can possibly be changed with communication and education. We can make better use of our time and energy if we can spot the difference. (Hint: True magat = Stupid)
Medicine is crazy
People in my health system send me PDFs of documents through the EHR
that I then have to print out
sign
and then have someone fax it back to the original person so they can put it back into the EHR
Classic Fred Luft #Nephrology 101 editorial on a study testing the effect of potassium supplement on natriuresis: Eliminating sodium with potassium 🔗 academic.oup.com/ndt/article/... #NephSky #MedSky 🧪
Universities that tout the benefits of AI without advocating hard for the changes required for our planet to support AI (read: rapid shift to 100% renewable energy, strict water reclamation and reuse rules) are not helping humanity
reminder to liberally check carbon monoxide levels during snowmageddon
CO levels can be measured on venous blood along with routine labs (no need for a separate arterial puncture)
emcrit.org/ibcc/co/ #EMIMCC
end-stage academia:
how to game the system to score more grants and publications
this is ultimately a zero-sum rat race that doesn't help patients or science
It seems to be a recurring problem, though. As you can see from the link above, Science's team found that several of these clinical centers have previously fouled up trial data for other companies and other drugs, and that alone should make any responsible CRO avoid them like radioactive waste zones. But the problems are even deeper. It appears that many of these Miami-area centers are cheerfully enrolling "professional patients" who are signing up for as many trials as possible to collect the payments and benefits, and who are likely as not throwing the pills themselves away. By this point in the article, my head was in my hands, and I'm sure that's a common reaction. This sort of idiotic fraud is the exact opposite of medical research.
Remember the TOPCAT story of what happened in Russia and Georgia?
This is worse: www.science.org/content/blog...
And in South Florida.
From @dereklowe.bsky.social
Overflowing ERs with 3 deaths in one ER waiting room
No room to offload ambulance patients
Admitted patients in the hallways
Edmonton (and everywhere else with a rip roaring flu season)
apple.news/AOw1VHQFjSxy...
a huge victory for universities, worth billions of dollars: Trump can’t cap indirect-cost rates on NIH grants, appeals court rules
www.chronicle.com/blogs/the-tr... via @andyandy.bsky.social
There’s something quietly comforting about the first week back after the holidays
The return of routine.
Kids back in school.
Headspace. 🙏
So neat!
Examples of common IV antibiotics and their sodium content:
- Ampicillin: 731 mg/dose → 2,924 mg/day
- Ceftriaxone: 55 mg/dose → 110 mg/day
- Metronidazole: 324 mg/dose → 973 mg/day
- Piperacillin-Tazobactam: 556 mg/dose → 1,668 mg/day
- Vancomycin: 885 mg/dose → 1,770 mg/day
What a joy it must be to work at an urgent care and just prescribe antibiotics for viral illness with wild abandon so you can later take credit for the work that the passage of time did.
All the best in one place!
What are the challenges of recommending bisphosphonates to patients who have normal bone density? Dr. Ann Garment discusses this in the latest episode of Beyond Journal Club, a collaboration between @coreimpodcast.bsky.social and NEJM Group. Full episode: nej.md/4q7hOK3
#MedSky
2/ Volume overload 🚫🟰 venous congestion
💧 Volume overload: evidence of excess extracellular volume
💧 Venous congestion: high back pressure leading to reversal of blood flor from RA into end organs, which can cause injury
Fruits & vegetables 🍊🥑🥦are ⭐️NOT⭐️ the problem.
❌Myth: restricting dietary K is useful to prevent hyperkalemia
❌Myth: Avoid fruits/veg - the main source of dietary K+
#Kidneywk
1/ 🚨 NEW episode on first line meds for Type 2 DM ‼️
Let’s dive in and discuss whether tried and true metformin vs. newer options, like SGLT2i or GLP1RA, are better for YOUR patient 🌊
🖥️: www.coreimpodcast.com/2025/11/05/d...
Had so much to say about HRS we had to split it into two episodes!
Check out part 2 on HRS treatment, Transplant, and a topic near and dear to my heart, palliative care.
It has been a dream to be able to be a part of my favorite podcast.
Check out this very fun episode on one of the most interesting diseases, Hepatorenal Syndrome!
1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome (HRS) part 1️⃣
AKI + portal HTN 🟰hepatorenal syndrome
🖥️: www.coreimpodcast.com/2025/10/15/h...
Answer: YES
Review the REVISE trial w/ @NEJMGroup below ⤵️
www.coreimpodcast.com/2024/12/11/s...
#TriviaTuesday
Does stress ulcer prophylaxis with a PPI reduce clinically-important bleeding compared to no prophylaxis in mechanically ventilated patients in a contemporary ICU setting?
And the great original video I discuss with @drjrubenstein.bsky.social is available at:
www.youtube.com/watch?v=BbNi...
#AdvanceCarePlanning
"After 30 years as a researcher, science communicator and university science teacher, I’ve been unsettled by what appears to be a growing skepticism of science among some of my Generation Z students..."
Some people mistakenly believe that skepticism *is* science.
Omg no Monica wtf 😔
Praying he gets home to you three soon 🙏🏾🙏🏾
My husband was detained by ICE today
Juan Muñoz, an American citizen, father of 2, and local government official, was peacefully protesting w. other elected officials. He was assaulted and taken away
I have had zero contact or updates since
#SOS
@duckworth.senate.gov @durbin.senate.gov
Hahah omg I didn’t appreciate that aspect of consistent lol 🤦🏽♀️🤦🏽♀️
