Gerald Creager

@RedBerr81559719 Inferoposterior OMI. I-aVL recip changes.

Second ECG 2 hours later:

52 years old male with chest pain since yesterday. Is this a STEMI to you? First Troponin 11,605, second 2hour later was 14,033.

@albertoortegana @DrAkhilX @IhabFathiSulima @dr_manish_ydv AF 2:1 block w/ LBBB

82 years old male patient suddenly collapsed. His blood pressure was 85/40 mmHg. What is your diagnosis..? #ECG,#ecgcompass,#ECGAtHome,#CardiacRehabilitation,#CardiologyCare,#CardiologyCare,#medical,#ecginterpretation,#cardiology @DrAkhilX @IhabFathiSulima @dr_manish_ydv @Dr_Shiv_kumar_ @DrMedica_13 @drobiy12 @hemo_shk

@LorickFoxPA @Timodc Yes, but does HE know it and what would Congress... or DOJ do if he tried?

@Timodc 🤦‍♂️🙄You know he can't do that right? 🤣🤣🤣🤣🤣🤣

It brings me no joy to say this but given the presidents shocking announcement that the Supreme Court is compromised by foreign interests, the next president will have no choice but to replace all 9 members with new justices who have no foreign entanglements.

@KarlTheProgrmr @drterrysimpson They would also probably not volunteer, and the study wouldn't be blinded because they would know they were in the control arm. They'd be treated differently by their providers.

@drterrysimpson How? If they weren't going to get it otherwise, then not giving it to them is not unethical. Is it unethical to give it to them?

There is a reason new influenza vaccines are not tested against saline. It’s called ethics. Once an effective standard of care exists, you do not randomize patients to “nothing” simply to satisfy rhetorical purists. You compare the new formulation to the existing vaccine. Why? Because the pillars of medical ethics are not decorative. Autonomy. Beneficence. Non-maleficence. Justice. Withholding a proven intervention during an active respiratory season, in order to produce a prettier placebo comparison, violates non-maleficence. You do not expose people to preventable risk for intellectual theater. A physician should understand this. Clinical trials evolve. The first polio vaccine was tested against placebo because nothing existed. Once polio vaccines worked, you compared improved versions to existing vaccines — not to sugar water. The same logic applies here. Demanding saline controls when an effective vaccine already exists isn’t scientific rigor. It’s performative skepticism untethered from ethics. Medicine does not exist to satisfy internet absolutists. It exists to reduce harm.

@drterrysimpson Those calling for true placebo-controlled trials for vaccine approvals don't understand, or choose to profess their ignorance, of why we don't employ a double-blind, RCT in some cases. Your statement is exactly correct. Bowden and Prasad are just wrong on all counts.

@nickmmark And then they brought him back. And we still have Bhattacharya, Makary and RFK Jr.

I’m reminded on the last time Prasad was fired/resigned from FDA

@expatriate_in @astathmeta @nickmmark It's a tool if you know what the strengths and weaknesses are. I'll argue that students on rounds shouldn't be making a care plan before rounds based on the DDx and some labs. Using LLMs to understand the case, with appropriate care makes sense.

@astathmeta @nickmmark It’s a tool.

It’s funny that people think LLMs would help “pass med school”. Do they think there are essays & problem sets?

@daoo100 @albertoortegana @awandr1 @CelestinoGutirr @ChShafiullah15 @Dr_Akuabata24__ @Dr_J_K_Kansal @Dr_Mofire @Dr_Shiv_kumar_ @DrAkhilX @DrRazi4 High dose steroid, so: B.

Drugs of choice for Patients with Acute Bell’s palsy? #MedX ? A) Oral Acyclovir alone B) Oral Prednisolone (started immediately) C) IV antibiotics + steroids D) Carbamazepine

@TrackYourHeart Or it could be E. Volume, preferably LTOWB. Norepi if SVR is in the gutter. Epi has both alpha and beta effect. It's not ideal for this regardless of ACLS dogma.

What is the first-line drug recommended in the management of PEA or asystole? A. Amiodarone B. Lidocaine C. Adrenaline D. Atropine

@PS_Alpha1 @AllEarsNet I'd rather close Joffries.

@AllEarsNet Starbucks, all of them.

Which Disney World restaurant needs to PERMANENTLY close?

@syamkumarmd AVRT's common post-op TOF surgery.

55 yrs old female, post-op TOF. presenting with palpitations. What is the likely cause and location of this tachy? Mapping data to follow #Epeeps

@DrRazi4 @PMcardioApp Inf wall ischemia, anterior ischemia with deWinter sign. Hyperacute T in V2-5. Primary LAD lesion, LCx flow issue, probably TIMI 1 or 2. Cath now, or thrombolysis if you're remote and no cath available.

46 y.o male; CKD 3A, HTN, came in with sudden onset chest pain; Stable VS; What do you think🤔❓Is there an occlusion😃❓ @PMcardioApp #CardioEd #Cardiology #CardioX #Medicalstudent

@therealrthorat @JeromeAdamsMD Based on the tone of the refusal letter, it was never certain FDA would reconsider. I suspect Prasad decided he could only get away with this for so long.

@JeromeAdamsMD Curious headlines given that the FDA didn't change its position at all. Moderna did. Moderna refiled as the FDA asked. FDA got what it wanted. Moderna had to agree to something it didn't: another study with the proper comparator.

🤔

@LorickFoxPA @JeromeAdamsMD I think it was just Vinay Prasad flexing his muscle. He's been anti-mRNA vax and a critic of vaccine trial protocols for a long time. And in his heart (or what ever he uses) he knows he's right. Think back to his, and Bhattacharya's screeds during the height of the Pandemic.

I would suspect that every healthcare provider in the United States reached out and indicated that they had taken leave of their senses. I suspect the initial decision was to "see if they could get away with it". They discovered very rapidly that they would not be permitted to get away with it.

@smithECGBlog What an excellent case. In the heat of resuscitation, my initial read would have been a "slow VT" until I had time to look at the ECG more carefully. I'd then have ID'd shark-fin, but AF is subtle in the throes of a resuscitation. Easy to miss initially.

Is this a wide complex rhythm? And what is the etiology (after you hear the history)? drsmithsecgblog.com/is-this-a-wide…

@OnlyEcg1 prox LAD vs LM. At least Cardiology will call it a STEMI and wake up the cath lab.

Culprit 🫀? #Cardiovascular #MedTwitter #CardioTwitter #MedicalStudents #MedicalEmergency #QoHBot #CathLab #ECG #STEMI #OMI #Paramedics #EKG #MedicalEducation #Cardiology #CardioEd #Cardiologist

@JordanC_MD @MaddiWulfeckMD Be nice. I used a bunch of the Edwards Labs SG catheters.

@MaddiWulfeckMD Depends on who you ask. If you ask certain folks it can’t be a swan-ganz catheter unless you broke out Dr swan’s 1970 prototype catheter with Dr. Ganz’s thermal dilution probe. All others are derivative and are therefore PA catheters! Yes I’ve been pimped on this before..

🚨 ICU line check...but there is something wrong here. 🫁📍What is the line? 😟 And what's the complication you're worried about? Drop your answer 👇 #Radiology #Radres #MedTwitter #RadTwitter #CXR

@MaddiWulfeckMD SG is too deep in the RPA. And the introducer is a bit deeper than I prefer. I'm concerned for R pulmonary infarct.

@therealrthorat @nickmmark I believe you're implying the previous administration's FDA leadership eschewed science? Not the experience I had. Prasad has stated his disdain for Moderna and mRNA tech already; this was his way to go farther to destroy them. Prasad's an open book, and very bad reading.

@nickmmark This is misleading. First, the FDA does not guarantee approval of a trial when they review it. It's especially true when the FDA changes leadership, where a prior, corrupt FDA cannot bind a new, science-based FDA to accept a substandard trial just b/c they "okayed" it...

Bad news for patients, doctors, and investors.

@pampoodlejr @JohnnyVomits @RpsAgainstTrump I've evolved to watching Disney World YouTube videos (including the ones on the Imagineers) and planning our next vacation. Our passports are up to date so that when we travel we can go from Colorado and be admitted to Florida unimpeded... "Papers, please!"

@JohnnyVomits @RpsAgainstTrump we don't. I don't believe anything that any of them say. I basically have given up watching the news about politics and I won't watch that orange subhuman at all.

HHS Secretary RFK Jr: “I'm not scared of a germ. I used to snort cocaine off of toilet seats.”