Ivan Shekerev

#VExUS versus CVP for assessing venous congestion: oasis or mirage?🔗Crit Care 30, 240 (2026). doi: 10.1186/s13054-026-06016-7 #POCUS #FOAMed Authors mention that, when done carefully, CVP can continuously monitor the risk of venous congestion and can be easily reassessed before and after interventions like a fluid bolus. But I think this overlooks the significant institutional variability in CVC use. For example, where I did my critical care fellowship, midlines were used far more commonly outside the cardiac ICU, so #POCUS often became the primary way of assessing these patients.

Regulatory capture is the game. After meeting a lot of Senators and Representatives, here’s the uncomfortable truth: most are not especially bright. But brilliance is not a prerequisite for grift. You do not need to be a genius to sell access, protect incumbents, repeat lobbyist language, or vote for a bill you barely understand. You just need the seat. The truly dangerous politicians are the smart ones. They understand the architecture. They accumulate power, money, committee influence, donor protection, and institutional cover. The mediocre ones rent themselves out. The brilliant ones build the machine.

The world’s only U.S.-patented ECG electrode Some people may assume that all ECG machines on the market are similar in quality and disease detection capability. In reality, this is not the case. High-end branded ECG machines generally deliver significantly better image clarity and disease detection rates than low-cost, lower-quality products. This difference primarily stems from superior signal processing technology. Big-brand ECG machines use chips that cost 20 times more than those in budget brands. This is the main reason they can display more detailed signals. This results in a substantial difference in image clarity and detail resolution. Regarding fragmented waves (notching) in the aVR lead, these are only occasionally visible on big-brand ECG machines and are not displayed consistently. Budget ECG machines almost never show them. Our ECG system achieves a 99% display rate for fragmented waves in the aVR lead. This exceptional performance is made possible by our use of the world’s only U.S.-patented ECG electrode, combined with multiple patented signal processing technologies. Our patented electrodes offer excellent resistance to interference, baseline drift, and hair artifacts. Even when used with major-brand ECG machines, they can significantly improve the visibility of fragmented waves in the aVR lead. We not only utilize this patent but have also developed our own exclusive electrode gel formula, which further enhances signal acquisition and anti-interference performance. In addition, our electrodes feature extremely strong adhesion, remaining securely attached even if the patient sweats heavily. They stay reliably in place during 24-hour Holter monitoring as well. Key Features: 1) Strong anti-interference 2) Prevents baseline drift 3) Reduces hair artifacts 4) Super strong adhesion — stays in place even when patients sweat PhysioSign USA

🌍✨ Celebrating #WorldNursesDay! 🩺💙 Today, we honour the heart and soul of healthcare—nurses. The European Resuscitation Council extends its deepest gratitude to nurses across the globe who dedicate their lives to saving others. Your skill, compassion, and commitment never go unnoticed. On this special day, we recognise your invaluable contributions to resuscitation and emergency care. You're at the forefront of medical care and the heart of every recovery story. Thank you for your relentless spirit and for being our everyday heroes! #ERC #RESUS26 #StrongerTogether #savelives Courtesy: Image created through AI

Oy. According to a new paper in The Lancet, the rate of made-up citations in biomedical papers has increased by more than 12x since 2023. thelancet.com/journals/lance…

For eleven years the CEO of one of the most "prestigious", if there is such a thing anymore, academic medical centers in America sat on the board of one of the largest pharmaceutical companies in the world. In twelve of his twenty-three published papers, he "forgot" to mention it. He is not unusual. He is just the one who got caught. Source: Michigan Daily. buff.ly/lnrCuw9

Neuralink progress

In 1817 the University of Michigan was granted tax immunity to run a school. In 2026 it is the most expensive healthcare in Michigan. The charter never updated. @dananessel @GovWhitmer @umichmedicine

A question arising from my last tweet... "What do you mean by #Zone1 ?"👇 Where is it? Zone 1 is the zone just before the first rise in the lactate curve. It encompasses the lowest lactate numbers that the individual athlete can get to. How wide is it? Wide enough to be a practical zone, i.e. 10-15 bpm below that point of the first rise in lactate to just before the first rise in lactate. What is it good for? 1/ A lot of training in Zone 1 will push the entire curve to the right. Zone 1 is the only zone that has this effect on the whole curve. With time (& with a lot of zone 1 contractions, the entire curve will gradually shift to higher power numbers. 2/ It typically coincides with maximal End Diastolic Volume, i.e, for most athletes the heart is maximally 'full' & 'stretched' at this point. Over time this leads to morphological changes that increase the size of the heart and enable higher cardiac output & higher #VO2max 3/ It favors #FatOxidation. By spending time in Zone 1, the #FatMax of the athlete will increase. Also, because a significant share of the energy comes from Fat, tolerance to Zone 1 training is much higher than the zones above. ##### Zone 1 is, IME, the most generally beneficial zone for most athletes & it should make up the bulk of the total training time.

SpaceX just casually dropped 45 payloads from 17+ countries across the globe into orbit on a single Falcon 9 flight (CAS500-2) Payloads included: • South Korea (CAS500-2) • USA • Germany • Italy • Greece • Singapore & more.. Before SpaceX, getting an international payload like this into orbit would have cost an absolute fortune. The industry was essentially forced to rely on slow, legacy launch providers Falcon 9's reusability did not just lower the cost to low-Earth orbit - it absolutely crushed it Space just opened up to the whole world at the cheapest price ever. Period.

I can't figure out if vaccines work or not. Tough one. Need Sherlock Holmes on this one.

This is an iron lung for polio victims It's in a museum where it belongs It will stay the Unless RFK Jr has his way and we stop vaccinating

This was before Starlink had a name

When primary hyperaldosteronism masqueraded as peripartum cardiomyopathy ow.ly/RJxO50YShrR #EHJCaseReports @Phiso_de @TJ_Yeo @aayshacader @BoldiKovacsMD @SukritiBanthiya @ANazmiCalik @O_Azizy_MD @saramoscatelli7 @EHJCREiC #CardioX

We should stop talking about automating science & autonomous scientists, because that’s just spin. We should instead talk about automating & standardising experiments & data collection.

Elon Musk: “You think that someone like Bill Gates who started a technology company that’s one of the biggest companies in the world, Microsoft —you think he'd be really quite, strong on the sciences, but actually, he's not strong in the sciences, He came to visit me at the Tesla Gigafactory in Austin and was telling me that it's impossible to have a long-range, semi-truck. And I was like, 'Well, but we literally have them, and you can drive them, and Pepsi is literally using them right now’ This was really surprising”

From the April issue: Coring Aspiration Thrombectomy or “CAT Pounce” Technique for Large Coronary Thrombi Resistant to Aspiration Alone ➡️ hubs.ly/Q04dQjdX0 @HadyLichaaMD @DLBHATTMD #cardioTwitter #cardioX #cardiology #interventionalcardiology

Drug Discovery should be renamed Drug Creation. This is because chemical space is so big you cannot search it, you must instead create.

People are handing over their DNA, their scans, their health records to research projects, AI wellness apps, genetic testing kits. UK Biobank alone has leaked 198 times in a year. Once that data is out, it identifies your kids and siblings forever and you can't take it back. reclaimthenet.org/uk-biobank-fai…

@yunta_tsai Tesla AI is where the rubber hits the road. “Make no mistakes” is not just a meme joke for self-driving AI. Tesla AI saves lives every day, at large scale. No other AI team can yet make that claim.