5 pearls is such a great series because even when itβs covering a topic I think I know well, thereβs always something important I learn β many such moments in this excellent episode.
15.10.2025 18:12 β π 1 π 1 π¬ 0 π 0@willpreston.bsky.social
Hospitalist in Bronx NY Interests include clinical epidemiology and med ed. Shasta connoisseur.
5 pearls is such a great series because even when itβs covering a topic I think I know well, thereβs always something important I learn β many such moments in this excellent episode.
15.10.2025 18:12 β π 1 π 1 π¬ 0 π 0PARAGON-HF was a negative trial but Iβm seeing the subgroup analysis being used to justify changing ACE or ARB to ARNI all the time without consideration of other patient-centered factors
11.10.2025 00:19 β π 1 π 0 π¬ 0 π 0What the DOTS trial of Staph bacteremia tells us:
β’ Dalbavancin d1 and d8 vs daily IVs for WEEKS
β’ No left-sided IE/CNS/prosthetics
β’ Dalba not superior by DOOR endpoint, but similar clinical outcomes.
Big implications for inpt care. More here! #IDSky tinyurl.com/3hjzkt96
Iβd like to nominate this case for a pulitzer prize
09.10.2025 20:22 β π 0 π 0 π¬ 0 π 0Initial imaging studies.
Case Record of the MGH: A 36-year-old man was admitted because of fever, hypoxemia, and bacteremia. Imaging revealed pulmonary opacities, thickening of the duodenal wall, and a thrombus in the right renal vein. A diagnosis was made. Full case details: nej.md/3KYBaAE
#MedSky
The NEJM case records this week is an all timer with Dr Dhaliwal. They do a Watson on jeopardy! style challenge where his answers are compared to an AIβs - should definitely read for yourself but just want to be the first to say humanityβs still got it baby!
08.10.2025 19:20 β π 0 π 0 π¬ 0 π 05/6π§΅Unauthorized immigrants contribute billions to the U.S. health system β more than they receive in care.
In 2017 alone, net contributions totaled:
$20.8B to Medicare
$21.3B to Medicaid
$14.7B to private insurance
They are net funders, not burdens.
Almost like people want socialized healthcare! Best we can do is cut the largest public insurance, replace vaccines with crank science, gut our research institutions, and prevent any new HCWs from coming here but hereβs an AI video of our demented president saying heβll make you live forever.
28.09.2025 12:03 β π 1 π 0 π¬ 0 π 0Thereβs a great one on thickened liquids. Also over using RPP.
26.09.2025 06:57 β π 2 π 0 π¬ 1 π 0Trump: donβt take acepitoemponoene
RFK Jr: *moth crawls out of mouth*
A nude man is in the background, only referred to as βthe colonelβ
Person watching on tv: well if they say so
Reading the blog awhile but turns out scrolling right past the podcast lol. Great ep. I guess even tho the 2mm in all 4 leads has LR 16, itβs from a case-control with only 4 such cases so is it really enough to go by? Seems straightforward enough to repeat a similar study tho maybe Iβll try.
17.09.2025 16:24 β π 0 π 0 π¬ 1 π 0You should go to the hospital if you break your spine
31.08.2025 22:22 β π 13 π 0 π¬ 2 π 0Always has been meme with the caption βwait itβs all volume statusβ
26.08.2025 03:02 β π 1 π 0 π¬ 0 π 0I am loath to report the most parsimonious diagnosis is scurvy. I recommend continued palliation with poultices as seen here or perhaps cauterization of the most severe lesions, as well as an extra portion each of hardtack and grog for the remainder of his voyage.
25.08.2025 01:47 β π 2 π 1 π¬ 0 π 0Every hospital in the US had immediate access to expert toxicologists (via poison control).
Most hospitals *lack* access to inpatient addiction medicine services.
Structurally, weβre great at resus, but then we often fail at chronic tx of substance use disorders.
jamanetwork.com/journals/jam...
This is correct. Any candidate cynically βtriangulatingβ on trans kids is a non-starter, and now is the time to say so. Thereβs still so much time to advance candidates that DONβT suck.
17.07.2025 01:03 β π 23161 π 4738 π¬ 408 π 398As clinicians there is little we can do about radiology interpretations, but should try to stick to the diagnostic algorithms and avoid relying on hunches. Missed PE has <5% risk of recurrence and mortality which is probably less than major bleeding risk from cumulative years on an unnecessary DOAC.
20.08.2025 20:43 β π 1 π 0 π¬ 0 π 0Writing up a case with my residents and shocked at what I'm learning about diagnosis of PE. PIOPED II the last RCT of CTA had a PPV of only 58% in the low risk group; more recent retrospective had 25% of all positive scans deemed false positive on expert review (including 16% of lobar PE).
20.08.2025 19:32 β π 1 π 0 π¬ 0 π 1ID doesnβt want us to read the forbidden trial
jamanetwork.com/journals/jam...
Iβve never wanted be embroiled in online cancel culture and I really hate to say this as a fan, but last night at the NY Liberty game I didnβt feel John Turturro was clapping with adequate enthusiasm during the Big Ellie Stomp.
06.08.2025 20:45 β π 1 π 0 π¬ 0 π 0Two and a half years from the last ep but at its best. Such great reflections on how we reason and how to improve. Iβll never conclude a case conference with βhigh index of suspicionβ ever again.
02.08.2025 01:24 β π 0 π 0 π¬ 0 π 0New hoofbeats letβs goooooo ππ€
02.08.2025 00:46 β π 1 π 0 π¬ 1 π 0Folk's...... The Tiny Desk
www.youtube.com/watch?v=Gh9p...
Itβs too bad she wonβt live! But then again, who does?
21.07.2025 18:54 β π 0 π 0 π¬ 0 π 0Diagnostic schema to help remember the causes of dyspnea organized hierarchically by organ system (lung, heart, blood, acid/base) now including a corner labeled "accidental aspiration of king cake baby to R mainstem."
Actually, I fixed it.
10.07.2025 20:19 β π 1 π 0 π¬ 0 π 0To help remind that ~20% starting the drug experience dyspnea (only 5% require stopping). Obvi some omissions on this schema.. pulmonary hypertension, neuromuscular weakness, other embolic sources like fat emboli or endocarditis, tense ascites, hepatopulm, aspiration of king cake baby to R mainstem
10.07.2025 20:11 β π 0 π 0 π¬ 1 π 0A diagnostic schema to help recall the causes of dyspnea arranged hierarchically by organ system (lung, heart, blood, acid/base) with another corner drawn on labeled ticagrelor
Major innovation in medical education: the dyspnea pyramid is now the dyspnea rhombus
10.07.2025 19:47 β π 1 π 0 π¬ 1 π 0You know things are bad when trauma surgeons are talking about Stoic philosophy.
Seriously, though, this is an interesting article. #EMIMCC
1/ π¨ NEW #5Pearls: Pleural Effusions π
Did you know up to 30% of pleural effusions of have more than one etiology?
Letβs dive in!
π₯οΈ: www.coreimpodcast.com/2025/07/09/p...
Sponsor: Oakstone CME
Featuring: @pulmpeeps.bsky.social