Leonel Campos
22.3K posts
@campos
Médico infectologista (CRM/SP 149049 RQE 50657). - Saúde, política e cultura. COI: married to @Deisy_Ventura
Viruses and Joint and Tendon Pain You had a cold two weeks ago. Nothing serious. But now your knee hurts more than it has in months. Your achilles is flaring. Your easy run felt like a half-marathon. You didn't do anything wrong. Here's what's actually happening...
Statement from the Lebanese Ministry of Health: Second Attack on Medical Teams in Less Than 12 Hours The Public Health Emergency Operations Center of the Ministry of Public Health issued a statement announcing that the Israeli enemy targeted medical teams in Siddiqine, Tyre District, while they were conducting rescue operations to recover the wounded and the bodies of martyrs from a previous airstrike. The attack resulted in the martyrdom of a paramedic from the Risala Association and the injury of two others. Additionally, two members of the Islamic Health Authority were wounded, and an ambulance was damaged. The Ministry of Public Health places this assault before the international community and humanitarian relief organizations as further evidence of the Israeli enemy's insistence on violating international laws and norms without accountability. Notably, this is the second direct targeting of paramedics in less than twelve hours, following the attack in Haris.
Lebanon - Around 2pm Sunday, Israeli forces struck a densely populated residential area in Beirut, only meters from Rafik Hariri Public Hospital, where MSF is supporting with an ER doctor. A mass-casualty influx followed: people bleeding, some carried on shoulders. In the first hour, 4 were killed and nearly 40 injured; more casualties are feared as rubble is cleared. “We are seeing elderly people and adolescents arriving with critical injuries to the head, chest and abdomen, including shrapnel wounds,” says Dr. Luna Hammad, MSF Medical Coordinator, from the ER at Rafik Hariri Public Hospital. “When strikes hit crowded residential areas without warning, the consequences are severe: both in human casualties and in hospitals’ capacity to respond.” MSF condemns this attack on civilians in a highly populated area and calls for the protection of civilians and health facilities. Strikes this close to a hospital spread fear and can stop people from seeking lifesaving care. MSF is donating a mass-casualty kit and will continue supporting hospitals with medical expertise and essential medical and non-medical supplies. Civilians cannot be collateral damage.
The IAEA has been informed by Iran that a projectile struck close to the premises of the Bushehr NPP this morning, the fourth such incident in recent weeks. Iran also informed the IAEA that one of the site’s physical protection staff members was killed by a projectile fragment and that a building on site was affected by shockwaves and fragments. No increase in radiation levels was reported. IAEA DG @rafaelmgrossi expresses deep concern about the reported incident and says NPP sites or nearby areas must never be attacked, noting that auxiliary site buildings may contain vital safety equipment. Reiterating call for maximum military restraint to avoid risk of a nuclear accident, DG Grossi again stresses the paramount importance of adhering to the 7 pillars for ensuring nuclear safety and security during a conflict.
💥The anti-war, anti-government protesters Netanyahu tried to keep home are beginning to gather in Tel Aviv– and elsewhere around the country. (Ofri EIitan/Danor Aharon)
Essa história do Guto Zacarias estigmatiza ainda mais o discurso contra o aborto, pq reforça a tese progressista que, no escurinho da vida privada, todo conservador aborta, caso necessário. O q mais assusta é a forma natural como ele discorre sobre os meios abortivos. Parabéns.
🩻Contrast-induced AKI: one of the biggest myths still shaping clinical decisions For decades we were taught: 👉 “Contrast damages the kidneys” 👉 “Avoid CT with contrast in CKD” 👉 “Hydrate, protect, delay imaging if needed” But what if… most of this is wrong?🤔 ->The uncomfortable reality Modern evidence shows: 👉 Low-osmolar contrast rarely causes true nephrotoxicity 👉 Even in CKD, AKI, and ICU patients 👉 The risk is often overestimated—or nonexistent So where did the fear come from? 📍 1950s high-osmolar contrast (actually toxic) 📍 Poorly controlled observational studies 📍 “Creatinine rise = contrast injury” assumption 👉 Correlation became causation 👉 And the dogma stayed ⚠️What recent data tells us ✔ No difference in AKI rates with vs without contrast ✔ No benefit from bicarbonate, NAC, or aggressive hydration ✔ Even ICU and AKI patients show no worsening outcomes ->Translation to real life 👉 The patient was going to develop AKI anyway...Not because of contrast!! ->The real problem: “Renalism” 👉 Avoiding necessary imaging 👉 Delaying diagnosis 👉 Choosing inferior tests And that leads to: ❌ Missed PE ❌ Delayed sepsis source control ❌ Worse outcomes ->Clinical mindset shift Instead of asking: 👉 “Will contrast harm the kidneys?” We should ask: 👉 “Will NOT doing the scan harm the patient?” ->Who still deserves caution? ✔ eGFR <30 ✔ Severe hemodynamic instability ✔ Multiple nephrotoxins Even then: 👉 Optimize volume 👉 Minimize dose 👉 Don’t delay critical imaging 🤓Bottom line ✔ Contrast nephrotoxicity exists… but is rare ✔ The fear is bigger than the risk ✔ The harm of NOT imaging is often greater In critical care 👉 We don’t treat creatinine 👉 We treat patients And sometimes… 👉 The most dangerous thing is NOT the contrast 👉 It’s hesitation. 📃Reference Florens N, Demiselle J. Kidney360 7: 445–449, 2026. doi: doi.org/10.34067/KID.0…
