AdolfoDíazC

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AdolfoDíazC

AdolfoDíazC

@adolfodiazca

Residente de Nefrología en el @NefroINCMNSZ| Medicina Interna en el @ABCcentromedico | Entusiasta de la educación médica continua en #medtwitter

Katılım Nisan 2012
419 Takip Edilen219 Takipçiler
Jonathan Chávez
Jonathan Chávez@JonathanNefro·
Evidencia emergente orienta a replantear el dogma histórico, y continuar explorando la utilización de cloruro de sodio para descongestionar de manera más segura y eficiente. Así es, sal para quitar sal 💁🏻‍♂️ JAMA Cardiology 2026 10.1001/jamacardio.2026.0938
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Ale Orozco
Ale Orozco@Ale_OrozcoINPer·
Thank you to all the nephrologists and gynecologists who visited us this year to learn a little obstetric nephrology, they are a pride for us. Many congratulations! Este año formamos en nefro obstétrica a más de 30 nefrólogos y a 20 obstetras.Muchas felicidades!
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Ashley Miller
Ashley Miller@icmteaching·
1️⃣ We can remove fluid at rates up to 12 mL/kg/h and blood pressure often holds. That limit isn’t arbitrary – it comes from dialysis data showing steep rises in hypotension and mortality above it. It marks the upper boundary of how fast plasma can be refilled from the interstitium and lymph 👇
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Ashley Miller
Ashley Miller@icmteaching·
1️⃣We talk endlessly about “capillary leak” – but most of what we say about it is wrong. Here’s what actually drives fluid movement across the microcirculation – and why Starling’s model needed an upgrade. A 🧵👇
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Ashley Miller
Ashley Miller@icmteaching·
Excellent response from Tom Woodcock – the real expert behind the extended Starling concept. He’s spot on: this paper repeats several old misunderstandings. Kinetic “volumes” (Vt1, Vt2) are fitted parameters, not anatomical spaces. Re-labelling the slow-exchange compartment as a “third space” confuses maths with physiology. At true steady state you can’t be oedematous and intravascularly dry – that’s a transient disequilibrium or an externally driven loss (bleeding, ultrafiltration). (Detailed thread coming on this soon) Calling it a “third space” ignores mass balance and extended Starling physiology. The irony is in the albumin section: the paper admits that hyper-oncotic albumin expands plasma by increasing lymph return, not by venular re-absorption. That’s exactly what the extended Starling model predicts – refill without re-absorption. Good kinetics ≠ good physiology. Until we see paired Pc, Pi, πc and lymph-flow data, “slow-exchange space” remains a curve-fit artefact, not a rediscovered compartment. #MedX #FluidTherapy #Physiology
Tom Woodcock@thomaswoodcock

@ThinkingCC @icmteaching @intensivaev @Rajiv_Sinanan @NephroP @khaycock2 @kyliebaker888 @ArgaizR @ABCDEcografia @MynephCC 1/n I wish Robert Hahn was on X so we could discuss, but let me explain what this most recent albumin hypothesis is about. I greatly respect Robert for his volume kinetic experiments, but they do nothing to improve our understanding of 'steady state' fluids physiology.

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ANDROMEDA-SHOCK
ANDROMEDA-SHOCK@AndromedaShock·
Our 6th Hemodynamic Monitoring and Tissue Perfusion Course (online, bilingual) is coming soon (Nov 19-21)! ANDROMEDA-SHOCK-2 will be extensively discussed there😍. Link in the poster below
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Ross Prager
Ross Prager@ross_prager·
(1/x) Andromeda-Shock 2 was just published in JAMA and is the most important septic shock trial in the past DECADE. They found that phenotyped resuscitation improves the composite outcome of mortality, vital support, and hospital LOS. Here's how you can apply this protocol to your practice 👇
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Dr. Miguel Ibarra-Estrada
Dr. Miguel Ibarra-Estrada@DrMiguelIbarra1·
The ANDROMEDA-SHOCK-2 is finally released!! We found that a personalized resuscitation targeting capillary refill time through simple bedside hemodynamic tools was superior to usual care for the composite of mortality/vital support/hospital stay and for faster decrease in SOFA.
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Pablo Galindo
Pablo Galindo@galindozip·
Les comparto nuestro nuevo Artículo Original Describimos, validamos y automatizamos un método para predecir urea y electrolitos post hemodiálisis, únicamente con la prescripción adequatorapp.com/hd-predictor BMC nephrology 2025 Léelo gratis 👇 doi.org/10.1186/s12882…
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Ahmed Mohsen
Ahmed Mohsen@drahmedmohsen85·
💊 Tips & Tricks in Beta-Blockers 🔹 Nebivolol: most selective β1 → best for asthma/COPD 🔹 Bisoprolol/Metoprolol: best rate control 🔹 Nebivolol: lowest ED risk 🔹 Carvedilol/Nebivolol: best BP effect 📘 From my book: Tips and Tricks in Cardiology ✉️ Type “tips” if interested
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Brenda Delgado
Brenda Delgado@Bren_981·
“Glomerular Diseases and Onconephrology: A Case-Base Review” Thanks to @Nephr0s for sharing your clinical and academic expertise in this expanding field. 🫘@NefroINCMNSZ
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