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xenwan

@xenwan

Internal medicine/Emergency Medicine πŸ₯ Echocardiography πŸ«€ POCUS πŸŽ›οΈ

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14.03.2025
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Latest posts by xenwan @xenwan

The game here is separating out people at high risk of CPM. If no malnutrition, liver disease, hypokalemia, alcohol use disorder, I say let it rip

06.03.2026 18:30 πŸ‘ 6 πŸ” 1 πŸ’¬ 0 πŸ“Œ 0
Original Article | MAR 11, 2026
Finerenone in Type 1 Diabetes and Chronic Kidney Disease (FINE-ONE)
Figure 1. Change in the Urinary Albumin-to-Creatinine Ratio.

Original Article | MAR 11, 2026 Finerenone in Type 1 Diabetes and Chronic Kidney Disease (FINE-ONE) Figure 1. Change in the Urinary Albumin-to-Creatinine Ratio.

In adults with type 1 diabetes and chronic kidney disease with albuminuria, the decrease in the urinary albumin-to-creatinine ratio was significantly greater with finerenone than with placebo. Full phase 3 FINE-ONE trial results: nej.md/4rTPAmu

#MedSky #EndoSky #Nephrology

04.03.2026 22:12 πŸ‘ 9 πŸ” 10 πŸ’¬ 1 πŸ“Œ 0
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RENOVATE Trial: HFNC vs BPAP in ARF
πŸ“Š Did HFNC match BPAP in 5 respiratory failure subgroups?
βœ… Non-inferior in 4/5
πŸ§ͺ Bayesian dynamic borrowing = statistical edge
🚫 Futility in immunocompromised patients
Read more πŸ‘‰ https://wp.me/pdrP8b-5sU
#FOAMed

03.03.2026 05:02 πŸ‘ 2 πŸ” 1 πŸ’¬ 0 πŸ“Œ 0
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Our March 2026 JASE is now online! bit.ly/3Yls18R

This issue features:
πŸ”· Two State-of-the-Art Reviews
πŸ”· Noninvasive Assessment of Mean Pulmonary Artery Pressure
πŸ”· Follow-Up of Neonatally Diagnosed Atrial Septal Defects and Patent Foramen Ovale at Preschool Age
πŸ”· And more!

03.03.2026 16:28 πŸ‘ 1 πŸ” 1 πŸ’¬ 0 πŸ“Œ 0
Diagram titled "Figure 1. Intravascular Volume Overload" from JAMA, published February 23, 2026, illustrating the pathophysiology of intravascular volume overload, including decreased cardiac output, jugular vein distention, and pulmonary edema.

Diagram titled "Figure 1. Intravascular Volume Overload" from JAMA, published February 23, 2026, illustrating the pathophysiology of intravascular volume overload, including decreased cardiac output, jugular vein distention, and pulmonary edema.

This Rational Clinical Examination evaluates the diagnostic accuracy of clinical examination, radiographic imaging, and laboratory testing in assessing volume overload in nonintubated patients.

Save this for your next clinical encounter: ja.ma/4aYIVQs

#MedEd

01.03.2026 13:00 πŸ‘ 7 πŸ” 4 πŸ’¬ 0 πŸ“Œ 0
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A man seeks the ED because of CP and dyspnea. Low sats, slightly tachycardic. He suddenly gets worse. #POCUS shows a clot in transit. Before Alteplase is given he goes into cardiac arrest. Luckily he only needs a couple of minutes of CPR after Alteplase is given. Full recovery. #EMIMCC

24.02.2026 08:09 πŸ‘ 6 πŸ” 3 πŸ’¬ 0 πŸ“Œ 0

How do you use it? Can you make an example? I use it to quickly find drugs indications and most frequent adverse redactions or to check evidence based algorithms for acute diseases. I struggle to find diagnostic help in it.

28.02.2026 17:46 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0
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Hands down the best #openevidence feature

28.02.2026 11:51 πŸ‘ 1 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0
28.02.2026 04:00 πŸ‘ 3 πŸ” 4 πŸ’¬ 0 πŸ“Œ 0

Hey the guy that makes the deepfake generator and suicide machine is gonna get into the murderbot business sounds great what could go wrong

28.02.2026 03:30 πŸ‘ 391 πŸ” 99 πŸ’¬ 6 πŸ“Œ 1
Preview
The "ChatGPT Health Will Kill You" Study LLMs can't triage, for the millionth time.

Don't trust ChatGPT Health – or likely any general health LLM – to give you medical advice in the context of a serious acute illness. Patient triage is clearly outside its functional requirements.
#medsky
www.evidencetriage.com/p/the-chatgp...

25.02.2026 20:58 πŸ‘ 7 πŸ” 7 πŸ’¬ 0 πŸ“Œ 0
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The evolution of acute pulmonary embolism classification (including the recently published 2026AHA/ACC/ACCP/ACEP/CHEST/
SCAI/SHM/SIR/SVM/SVN Guideline):

#foamed #foamcc #meded #Medsky #emimcc

22.02.2026 21:35 πŸ‘ 14 πŸ” 6 πŸ’¬ 1 πŸ“Œ 2
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It's not often in Pharma that you run a head to head trial against your major competition and legit just flat out lose.

Cagrisema 23.6% weight loss vs Tirzepatide 25.5% weight loss over 84 weeks.

This result is horrid for Novo Nordisk.

23.02.2026 11:57 πŸ‘ 16 πŸ” 3 πŸ’¬ 5 πŸ“Œ 1
Preview
The Human is the Floppy Disk | ENTREPRECARIAT Everyone is an entrepreneur. Nobody is safe.

networkcultures.org/entreprecari...

22.02.2026 20:01 πŸ‘ 0 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0
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This one hits hard.

21.02.2026 22:59 πŸ‘ 35629 πŸ” 10540 πŸ’¬ 778 πŸ“Œ 592
A head with medical icons above it, including a stethoscope, ambulance, and medicine. Text: "ICE Raids Are Jeopardizing Health Care Access JAMA Medical News"

A head with medical icons above it, including a stethoscope, ambulance, and medicine. Text: "ICE Raids Are Jeopardizing Health Care Access JAMA Medical News"

Policy changes involving ICE enforcement and CMS data sharing with immigration authorities have raised concerns about reduced #Medicaid participation and limited health care access among immigrant patients.

Learn more in the JAMA Medical News podcast: ja.ma/467BG7p

15.02.2026 16:00 πŸ‘ 8 πŸ” 8 πŸ’¬ 0 πŸ“Œ 0
An illustration summarizing the results of the QWINT-1 trial

An illustration summarizing the results of the QWINT-1 trial

The latest episode of Beyond Journal Club from @core.im.podcast and NEJM Group reviews the T2D medication toolkit clinicians use every day and then dives into new evidence on once-weekly insulin to help you individualize therapy while reducing treatment burden. Full episode: nej.md/4qqsXnV

#MedSky

15.02.2026 17:01 πŸ‘ 6 πŸ” 3 πŸ’¬ 1 πŸ“Œ 0
Insulin Bolus in DKA  #criticalcare #emergencymedicine
Insulin Bolus in DKA #criticalcare #emergencymedicine YouTube video by EMSwami

Insulin bolus typically not necessary in DKA but, consider if:

Delay in getting insulin drip from pharamacy.

Severe acidosis: reach therapeutic levels faster + fix the acidosis faster

Bolus dose: 0.1 U/kg

youtube.com/shorts/pYybS...
#EMIMCC

13.02.2026 14:49 πŸ‘ 11 πŸ” 4 πŸ’¬ 4 πŸ“Œ 0
A visual representation of the ADAPT AF-DES trial, which examined the effects of anticoagulant monotherapy as compared with combination anticoagulant and antiplatelet therapy in patients with atrial fibrillation who had received a drug-eluting stent at least 1 year earlier.

A visual representation of the ADAPT AF-DES trial, which examined the effects of anticoagulant monotherapy as compared with combination anticoagulant and antiplatelet therapy in patients with atrial fibrillation who had received a drug-eluting stent at least 1 year earlier.

ADAPT AF-DES trial: In patients with atrial fibrillation and drug-eluting stents, the optimal antithrombotic therapy after 1 year is unclear. Research findings on anticoagulant monotherapy vs. combination antithrombotic therapy in these patients are summarized in a Quick Take video. nej.md/4a7UsOj

15.02.2026 20:01 πŸ‘ 2 πŸ” 1 πŸ’¬ 0 πŸ“Œ 0

1) acetazolamide for iatrogenic contraction alkalosis is standard tx IMHO (most drugs are "off label") along with K repletion etc

2) PO acetazolamide probably fine, great bioavailability

3) prevention with amiloride is great, I love amiloride

4) triamterene is maybe nephrotoxic so less of a fan

13.02.2026 17:23 πŸ‘ 8 πŸ” 2 πŸ’¬ 0 πŸ“Œ 0
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πŸ” Notable mimics of cellulitis include (but are not limited to):
- Stasis dermatitis
- Lymphedema
- Contact dermatitis
- Lipodermatosclerosis
- Eosinophilic cellulitis
- Deep vein thrombosis

12.02.2026 18:53 πŸ‘ 3 πŸ” 1 πŸ’¬ 1 πŸ“Œ 1
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There is nothing magical about formal ultrasounds for appendicitis. We EM docs can do it too! 32 y old male with a classic history, CRP 94. #POCUS shows an appendicolith and an inflamed appendix. Surgeon moves up the operation because of risk of perforation. #EMIMCC

13.02.2026 05:09 πŸ‘ 2 πŸ” 1 πŸ’¬ 0 πŸ“Œ 0
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it's wild how badly people dose hypertonic therapy

60 ml of 23% is equivalent to ~500 ml 3%, so this article makes no coherent sense

best approach: figure out the sodium change you want and calculate the hypertonic dose

math sets you free from dozens of contradictory consensus statements #EMIMCC

11.02.2026 21:15 πŸ‘ 15 πŸ” 4 πŸ’¬ 1 πŸ“Œ 0
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#PaperinaPic summarizing the Queen of Hearts artificial intelligence study to read ECGs by the Queen of Infographics, @kirstychallen.bsky.social #MedSky
thesgem.com/2026/02/sgem...

12.02.2026 13:38 πŸ‘ 2 πŸ” 1 πŸ’¬ 0 πŸ“Œ 0
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Among patients with acute ischemic #stroke due to non–large vessel occlusion, #tenecteplase administered 4.5 to 24 hours after symptom onset increased excellent outcomes but raised the risk of intracranial #hemorrhage. #ISC26

πŸ“½οΈ Watch the video & read the full study: bit.ly/4kgH1yQ

06.02.2026 14:37 πŸ‘ 9 πŸ” 4 πŸ’¬ 0 πŸ“Œ 0

Daily Pearl:

Type B lactic acidosis should be considered in patients receiving high doses of beta 2 agonists (albuterol) which can cause a dramatic non-hypoxic rise in lactate.

Source: CPS - November 26, 2025 VMR with Sharmin & Rahul - SOB, cough, malaise

05.02.2026 22:00 πŸ‘ 1 πŸ” 1 πŸ’¬ 1 πŸ“Œ 0
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CANADA NEWS: University of Toronto Family Medicine Chair and basic income advocate Dr. Danielle Martin has been nominated to replace former Deputy PM Chrystia Freeland in upcoming Toronto by-election (University-Rosedale)

The healthcare case for guaranteed income security is overwhelming.

03.02.2026 03:24 πŸ‘ 169 πŸ” 71 πŸ’¬ 8 πŸ“Œ 7
The New England Journal of Medicine                      
Olezarsen for Managing Severe Hypertriglyceridemia 
A Research Summary based on Marston NA et al. | 10.1056/NEJMoa2512761 | Published on November 8, 2025 

Visual representations of the patients in the trial and the treatments they were assigned.       

Read the full Research Summary at NEJM.org.

The New England Journal of Medicine Olezarsen for Managing Severe Hypertriglyceridemia A Research Summary based on Marston NA et al. | 10.1056/NEJMoa2512761 | Published on November 8, 2025 Visual representations of the patients in the trial and the treatments they were assigned. Read the full Research Summary at NEJM.org.

In the phase 3 CORE-TIMI 72a and CORE2-TIMI 72b trials involving patients with severe hypertriglyceridemia, olezarsen led to a significantly greater reduction in the triglyceride level and in acute pancreatitis events than placebo. Full results and Research Summary: nej.md/491XG5V

#MedSky

01.02.2026 20:00 πŸ‘ 10 πŸ” 3 πŸ’¬ 0 πŸ“Œ 0

When managing patients with ischemic #stroke, can we please adopt a single BP target? Currently, BP should be <185/110 mmHg prior to thrombolysis & <180/105 after, which feels unnecessarily complicated. Wouldn't it be simpler to use one target, such as <180/100 mmHg, for both?

01.02.2026 16:53 πŸ‘ 8 πŸ” 4 πŸ’¬ 2 πŸ“Œ 0
Black-and-white satirical movie poster. Melania Trump is in a tailored black suit and high heels sits sideways on a white toilet, legs crossed, staring coolly at the camera against a stark white background. Large bold title at the top reads β€œMELAENA,” with the subtitle β€œTelltale sign of GI bleed.” At the bottom, bold text states: β€œIf you don’t have an ulcer, this movie will give you one.” A parody studio logo in the lower right reads β€œBROWNNOSE STUDIOS.”

Black-and-white satirical movie poster. Melania Trump is in a tailored black suit and high heels sits sideways on a white toilet, legs crossed, staring coolly at the camera against a stark white background. Large bold title at the top reads β€œMELAENA,” with the subtitle β€œTelltale sign of GI bleed.” At the bottom, bold text states: β€œIf you don’t have an ulcer, this movie will give you one.” A parody studio logo in the lower right reads β€œBROWNNOSE STUDIOS.”

I'd consider watching this if it counted as CPD points.

#medsky #FOAMed #GIbleed #EmergencyMedicine #IfInDoubtScopeIt

28.01.2026 22:23 πŸ‘ 10 πŸ” 1 πŸ’¬ 3 πŸ“Œ 0