Johnny
723 posts


The Invisible Glass Experiment
Scientists once conducted a fascinating experiment with a pike and an aquarium.
They placed a transparent glass barrier in the middle of the tank. On one side was a large, hungry pike. On the other side swam several small fish.
As soon as the pike spotted the smaller fish, it launched itself forward to attack.
Bang! It crashed headfirst into the invisible glass and was thrown backward.
Undeterred, the pike tried again... and again. Each attempt ended the same way a painful collision. After repeated failures , its head became bruised and some of its scales were knocked loose.
Eventually, the pike gave up. It retreated to a corner of the tank, clearly frightened and defeated.
Then, the scientists quietly removed the glass barrier.
The small fish now swam freely around the entire aquarium some even passing right in front of the pike’s mouth.
But the pike never attacked again.
Even though it was starving, it refused to strike. In its mind, the invisible wall was still there.
A few days later, the pike died of starvation surrounded by abundant food it could no longer bring itself to eat.
This phenomenon is known as the Pike Effect (or Pike Syndrome).
It serves as a powerful metaphor for how repeated failures and setbacks can create invisible mental barriers that limit us long after the real obstacles have disappeared.
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@StrokeAHA_ASA Transcranial, micro, emboli detection has over 20 studies demonstrating the ability to categorize low risk from high risk (stable versus unstable) parentheses carotid plaque
Inexpensive widely available
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Article Commentary: “PET Imaging of Carotid Atherosclerosis: Methodology, Implications, and Applications in Neurovascular Disease”
In this #BloggingStroke post, Natalie Neale discusses #Stroke article by Bhakta et al. ahajournals.org/do/10.1161/blo…

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@DutchRojas How were Mayo and Cleveland clinic able to set up hospitals on the East Coast and West Coast of Florida?
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@LeonardoRandial @farkomd @docpark @GAEscobarMD Also good for bail out vessel control
Non-virgin scenarios
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We hired a consulting firm to tell us why our profits are down.
They sent three 24-year-olds wearing vests.
They spent two months interviewing us about our own jobs.
Then they put our answers into a PowerPoint presentation.
They charged us $250K for this privilege.
During the final readout, one of them used the phrase synergy optimization without blinking.
I looked around the conference room.
Our CEO was nodding like he just received the Ten Commandments.
The grand conclusion was that we need to increase revenue and decrease costs.
I could've told them that for a gift card to Panera.
But nobody listens to the guy who works here.
You only listen to the guy who flies in on a Tuesday.
I'm updating my resume to include synergy optimization.
It feels like the right move.
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Mi padrastro, Jorge, nunca me dijo "Te quiero". Era un hombre duro. Trabajaba en la construcción. Llegaba a casa, comía, dormía. Pagó mi universidad. Pagó mi coche. Pero nunca me abrazó. Siempre pensé que me guardaba rencor. Yo no era su verdadero hijo. Jorge murió de un ataque al corazón la semana pasada. Estaba limpiando su camioneta. En la guantera, encontré una libreta desgastada. Era un diario. Entrada 1: Hoy conocí a una mujer con un niño. El niño parece triste. Quiero hacerlo sonreír. Entrada 50: El niño necesita aparatos. Estoy haciendo turnos extra. Entrada 200: Hoy se graduó. Me quedé atrás para no avergonzarlo con mi ropa de trabajo sucia. Nunca he estado más orgulloso. Entrada 500: Ojalá supiera cómo hablar con él. Solo espero que sepa que moriría por él. Me senté en el asiento del conductor de su camioneta polvorienta y lloré hasta que no pude respirar. No lo dijo con palabras. Lo hizo. Todos los días.
El amor no siempre se expresa con palabras. A veces, se manifiesta en manos callosas y espalda cansada.
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@Mr_Husky1 Wonderful to be in a family of bummer lambs, not a bummer at all
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Every once in a while, a ewe will give birth to a lamb and reject it. There are many reasons she may do this. If the lamb is returned to the ewe, the mother may even kick the poor animal away. Once a ewe rejects one of her lambs, she will never change her mind. These little lambs will hang their heads so low that it looks like something is wrong with its neck. Their spirit is broken. These lambs are called “bummer lambs.” Unless the Shepherd intervenes, that lamb will die, rejected and alone. So, do you know what the Shepherd does? He takes that rejected little one into His home, hand-feeds it and keeps it warm by the fire. He will wrap it up with blankets and hold it to His chest so the bummer can hear His heartbeat. Once the lamb is strong enough, the Shepherd will place it back in the field with the rest of the flock. But that sheep never forgets how the Shepherd cared for him when his mother rejected him. When the Shepherd calls for the flock, guess who runs to Him first? That is right, the bummer sheep. He knows His voice intimately. It is not that the bummer lamb is loved more, it just knows intimately the One who loves it and has experienced that love one on one. So many of us are bummer lambs, rejected and broken. But He is the good Shepherd. He cares for our every need and holds us close to His heart so we can hear His heartbeat. I am a bummer lamb adopted and loved by The Good Shepherd!! Hallelujah!!

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650 light-years away, the red supergiant Betelgeuse is living on borrowed time.One of the brightest stars in our night sky, this colossal star is a supernova in waiting. When it finally detonates, the explosion will be so ferocious that, even from this immense distance, it could briefly outshine the full Moon and turn night into day for weeks. For a short, dazzling time, Betelgeuse may even rival the brightness of the entire Milky Way, painting our skies with a light show unlike anything humanity has ever witnessed. The countdown to its dramatic death has already begun.
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Septic shock is not one disease
It is a physiological spectrum.
This editorial in Annals of Intensive Care reframes early hypotension in sepsis:
👉 Not “give fluids first”
👉 But “identify the mechanism first”
Three key profiles
• Hypovolemia → fluids
• Vasoplegia → early norepinephrine
• Cardiac dysfunction → inotropes
The problem:
Most patients have mixed phenotypes.
The solution
Use simple bedside physiology
CRT, PP, DAP, DSI
This is the shift from protocolized care to precision resuscitation
And it is already supported by trials like ANDROMEDA-SHOCK-2
We are not treating numbers
We are treating physiology
dx.doi.org/10.1016/j.aico…
#CriticalCare #Sepsis #Hemodynamics #ICU #PrecisionMedicine

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The inferior pancreaticoduodenal artery (IPDA), the usual first major branch of the superior mesenteric artery (SMA), typically originates very proximally—often just a short distance from the SMA's origin at the abdominal aorta.
### Typical Distance in Millimeters
Standard anatomical descriptions and cadaveric/surgical studies indicate the IPDA arises within the first 10–30 mm (roughly 0.5–3 cm) distal to the SMA's origin from the aorta.
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Image fusion helped a bunch!
After IVL + covered stent, quite happy with the end result.
#SMA #IR #CallVascular
@rbarbosa91

Necio Lizola MD@ReneLizola
🔴Superior mesenteric artery (SMA) occlusion. Chronic mesenteric ischemia. Fear of food, weight loss.
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