Francisco Santamaría, MD

Sign him to Real Madrid immediately

@tablemon @NsZoruaTCG Yea, i just think it has too much hype because its kinda the "newish" archetype as when Feraligatr won CL and everybody was playing it but then didnt do anything Por cierto bro me encanta tu canal, un gustazo platicar. Tambien soy 🇲🇽 pero vivo en 🇺🇸, espero un dia coincidir 🤘🏽

@SantamariaFcoMD @NsZoruaTCG Absolutely. The question wasn't which is better Arboliva or Dragapult because one is clearly better than the other. I'm just pointing out its strengths, not arguing over it being better

maybe im missing the potential of arboliva but 120 doesnt seem crazy like yeaah it spreads but like 1. shaymin 2. dragapult spreads better

@tablemon @NsZoruaTCG Its more threatening that 6 damage counters but no way its more threatening than 6 damage counters plus 200 damage on active. Also the 2-3 turns that you know the pult is coming are not in vain as you have your draw engine built in with drakloak

@NsZoruaTCG KOing one key Pokemon is sometimes more than enough to gain am advantage 120 damage despite being blocked by Shaymin is still more threatening than 6 damage counters Also the broken Stadium for Arboliva, as opposed to 2-3 turns where you know the Pult is coming

🩻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…

@StecherCro Can we call it DRAGAKAZAM?

KazamPult🔮🔥 フーディン / ドラパルト! Cool post-rotation deck featuring a lot of draw power, spread attack, high damage and Togekiss to draw extra prizes against other one-prize decks. 😊 Looking forward to watching the Champions League 🇯🇵 Good luck to everyone attending 🔥

Aquí en EU casi todos los hospitales tienen integrada IA en el exp. elec. para q te escriba la nota automáticamente mientras hablas con el paciente. Casi todas las notas son plantillas para ⬇️ el papeleo y enfocarte en lo que importa: estudiar y el paciente. Y en MX se enojan 😂

Benito rompió tuiter. Literalmente. Grande conejo malo! #SuperBowl

@Nefrosaurus Ivu de catéter central 😂

Paciente en hemodiálisis baila samba y suda como si estuviera e sauna, Catéter temporal con más de 4 semanas. ( obvio ….Bacteremia) Diagnóstico en urgencias: foco urinario. Tratamiento: nitrofurantoína y bendiciones. El catéter colonizado cocinando biofilm a fuego lento, la bacteremia tomando café en primera fila, y la farmacología aplicada como si la concentración sérica fuera un mito urbano. Uno no se enoja… solo contempla formándose en silencio clínico. 🫠

@StecherCro Goat

Huge congrats to Stiborg for another Top 8 with DawnZard. Amazing upcoming player to keep an eye out for!🔥 Talked about the change in the guide, and I am looking forward to showcasing what I cooked for the variant in the Ascended Heroes format guide update coming this week! 🤠

@TrentonBless @ryanltonge Thats because the judge was our boy phtephen 😂

@ryanltonge That’s pretty bad if it wasn’t caught by anyone at that table that his deck wasn’t shuffled. That’s what I’m more concerned about.

@brian_rifkin And then they say ah yea they've been peeing in the toilet 🥴

Me looking for the foley in an ICU patient who has just gotten 100 mg IV lasix #NephTwitter

Thanks @StecherCro! Ive won two consecutive locals plus a third place in our last challenge with a total record of 11-1-0 (and my loss was in part due to mistankenly passing instead of KOing a lonely Pidgey 🤦🏽‍♂️) thanks to your list and guidance. Really appreciate your effort!

@Tocelot @PokemonTCG I think it's just easier to have it as an app instead of browser -> website, etc. but i just added it to my home screen as a direct access and it works perfectly so nevermind 😅

@SantamariaFcoMD @PokemonTCG Hah thank you - it’s responsive so it should work on mobile as a website already, but what do you want to see in a native app specifically?

built a @PokemonTCG tournaments app with Claude Code since official app is not great - grabs all local tourneys within 100 miles of a zip - pulls top decks + card counts from regionals - tracks trending TCG creators & videos personalized app building today is wonderful

@PrizeMapTCG @twinleafgg @The_EPSD That sounds great. Thanks!

@SantamariaFcoMD @twinleafgg @The_EPSD I know this was asked before, but we’ve been completely sidetracked with adding the new sim for the last few weeks. Hoping now to allocate some time to try and determine a fair price soon!

Version 1.7.0 has been approved for both iOS and Android! Welcome back, playing in the app! Go to PrizeMap.app to grab it. All but 2 of our featured puzzles are in-app, with plans to update community puzzles this week! (New sim powered by @twinleafgg /@The_EPSD )

@PumasMX ¡GRACIAS AFICIÓN!

Con orgullo y la convicción de fortalecer nuestra historia, presentamos oficialmente a los nuevos integrantes del Club Universidad Nacional. Bajo el liderazgo de nuestro vicepresidente deportivo, Antonio Sancho, damos la bienvenida a los jugadores que defenderán nuestros colores con unión, confianza y trabajo: Antonio Leone y Jesús Rivas – Defensas Jordan Carrillo y César Garza – Mediocampistas Juninho Vieira y Robert Morales – Delanteros 📹 En vivo 👉 youtube.com/live/uC2kZMD_3… #UnidosPorLaHistoria

Huge fire in Denver, Glendale area right now

@KaiserF57 @StratCons Si jaja, era así o ponerle un papel calca, pero hasta el papel calca era escaso y tenias que tener el tuyo en tu bolsita 🥲

@SantamariaFcoMD @StratCons 😂 y de verdad así funcionaba?!

Hoy comí con un médico que es -seguramente- el mayor experto en Inteligencia Artificial en salud en Europa. Al preguntarme él, el estado de la AI en los servicios de salud en México, me dolió explicarle que en el sistema público de salud, aún se usan máquinas de escribir. 😥

@brozki19 @LyricOfWisdom No lo necesitas, en cuanto sospechas que hay watchtower le cargas energia al pidgeot y quitas el estadio con su ataque

@LyricOfWisdom Juego chari dawn y ahora tengo que jugar esto

Are you currently playing this card in your deck? Why or why not?