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@NDTsocial selected my RBC cast image for their September issue! ๐ฅณacademic.oup.com/ndt/issue/39/9 thank you @hjanders_hans and thank you @jrseltzer ๐คฉ for teaching me everything I know about #UrineMicroscopy ๐ฌ
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3.3K posts
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@rmohty
@KUInternalMed @sonostache @StanfordNeph @glomcon @StanfordCCM
Palo Alto, CA Katฤฑlฤฑm Ekim 2016
672 Takip Edilen639 Takipรงiler
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๐ Review:
Infection risk mitigation with complement inhibitors in kidney disease
doi.org/10.1093/ndt/gfโฆ
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Incidental finding of uric acid crystals in #UrinarySediment - polarized light, darkfield, and oblique illumination - orig mag x400 - #UrineMicroscopy
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again for the people in the back:
urinary tract infection is an EXCEEDINGLY rare cause of nosocomial fever or sepsis.
most such โcasesโ are probably misdiagnoses.
cystitis happens, for sure, but isolated cystitis doesnโt cause fever or sepsis.
Brad Spellberg@BradSpellberg
@emedfocus @ABsteward I think youโve missed the point. Iโve been doing inpatient medicine for 27 years. Iโve never seen a hospital onset pyelonephritis. No one else i know has either. What youโre talking doesnโt happen. You are being fooled by urine and missing the actual source.
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@kidney_boy @witchdrkochi @ebtapper may just be genes affecting hemoglobin biology (and thus messing with the lab), not actually diabetes/hyperglycemia/insulin resis per se
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@witchdrkochi @ebtapper I'm slower than you. Please explain
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Went to a lecture long ago
Speaker did a GWAS for diabetes
Discovered that iron metabolism and heme genes caused diabetes!
TINY p values
CAUSAL effects, because genes
Then, from the audience, a question
โHow was diabetes defined?โ
Answer: hgb A1c
Stunned silence
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On World Hypertension Dayโฆshiny new tool in our toolkit to benefit our patientsโฆ.Baxfendy approved in the US as the first and only aldosterone synthase inhibitor treatment for adults with hypertension astrazeneca.com/media-centre/pโฆ
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@nickmmark at least it's not AI slop ๐
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Thatโs not a infographic guys.
An Infographic uses graphics to convey information.
Thatโs just an all text handout with some mouse clip art ๐
CHEST@accpchest
In this infographic from the #CHESTInfections and Disaster Response Network, PCCM clinicians will find details on the epidemiology of hantavirus, how it can be diagnosed, symptoms to look for, treatment options, and more: hubs.la/Q04gNJv90
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@ATSCritCare become more familiar as in never use it? x.com/PulmCrit/statuโฆ
๐๐ค๐จ๐ ๐๐๐ง๐ ๐๐จ ๐@PulmCrit
new, larger RCT on selective decontamination of the digestive tract in NEJM shows that its ineffective SDD would eventually lead to drug-resistant organisms (beyond the timeframe of RCTs) SDD is an intellectual wasteland that ignores the whole field of antimicrobial stewardship
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NEW recommendation for Selective Decontamination of the Digestive tract (SDD) in mechanically ventilated patients, which all of us in the US will have to become more familiar with.
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This was an absolutely garbage study.
It used mortality as an endpoint and assumed an impossibly large effect size. It excluded the sickest patients and had significant crossover.
All the authors did was waste money on a trial that was certain to be negative.
ATS Crit Care@ATSCritCare
EVERDAC trial examined deferral of art lines in critical illness, showed deferral of art lines was non-inferior to cuff pressures. Caveat: 15% in cuff pressure arm got an arterial line for meeting prespecified safety thresholds nejm.org/doi/abs/10.105โฆ
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@Grendwhich In dozens of studies of real world CPR, mechanical compression was not associated with any improvement in survival - and many studies have found worse neurological outcomes.
pmc.ncbi.nlm.nih.gov/articles/PMC95โฆ
sciencedirect.com/science/articlโฆ
scholars.uthscsa.edu/es/publicationโฆ
thelancet.com/article/S0140-โฆ
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ICU doc here.
This is a cardiac arrest not a heart attack and this is terrible resuscitation. Not managing the airway. Trying - unsuccessfully - for a hand IV. The LUCAS device looks malpositioned and its use is associated with worse neurological outcomes than manual CPR.
Tansu Yegen@TansuYegen
Dubaiโs emergency response looks like the future: a man collapses from a heart attack, paramedics arrive within minutes, strap on the Lucas 3 automatic CPR device, and revive him right there. ๐จ
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@DrOribaDan @JumahL62826 @TSM_Humanist @docakx @Internist_02 @agnmu_Ug @ACCESS_UG @CelestinoGutirr @DMavine @ps_lukwago @DennisPhd1 @Asadthegeek @dr_katumwa @Drwafulafrnco @SemitalaFred Actually, it is quite a simple but rare case.
Urine examination should be a bedside or a side room tool
At least this is what my teacher @YaleNephrology @MPerazella taught us every single clinical round.
We even donated a microscope to @kirudduNRH for this.
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this new SCCM guideline is comedically pointless.
full of sound and fury, signifying nothing.
PulmCCM@PulmCCM
open.substack.com/pub/pulmccm/p/โฆ New Guideline on care for older adults in the ICU. Isn't that just "care in the ICU"?
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โThis is all really, really unfortunate - for vasculitis patients most of all, but for the integrity of the whole clinical trial/drug approval process as well. We really donโt need this sort of thing right now- hell, we never have, but especially not now.โ
science.org/content/blog-pโฆ
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Frequentist statistics have limitations, but the limitations are well known & the rules of the road are generally fair
Itโs increasingly common for Bayesian statics go WAY off the rails due to excessively optimistic priors
Swapnil Hiremath @hswapnil.medsky.social@hswapnil
@brian_rifkin @Nephro_Sparks @NephRodby @kdjhaveri @javo_neyra @asnpublications Here it is @CristinaDeReins breaks down the polymyxin and Bayesian voodoo nephjc.com/news/2026/shorโฆ
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The A5C can still underestimate the LVOT VTI it appears perfectly aligned if the jet is off in the orthogonal plane (or Z plane) to the A5C. I usually check an A3C LVOT VTI in addition to the A5C as an internal quality check.
NephroPOCUS@NephroP
4โฃ In such cases โ๏ธ, you can try the apical 3-chamber view (apical long-axis view with the probe marker directed toward the right shoulder from the apical window). Sometimes, it gives you a better Doppler angle. #POCUS
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Great, and expanded opportunity to join fellow cohort #4 of the program!
ASN EPC@AsnEpc
Calling fellows: @ASNKidney Home Dialysis Scholarship deadline is Sunday, May 31! You receive HDU registration, travel support, and immersive in-person and virtual learning that strengthens confidence in prescribing and managing home dialysis therapies.โก๏ธasn.kdny.info/Cjbh50YWNr0
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@EMPoisonPharmD "you get 1 figure"...
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graphs just hit harder in 1940
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@VLSorrellImages @CASEfromASE @ASE360 AI image @CASEfromASE ? where's the RML of the lung, weird venous tube down the midline? capiliary mispelling?
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We learned of an error to the online link... so, please try this instead to read this report in @CASEfromASE (as we fix the link):
cvcasejournal.com/article/S2468-โฆ
@ASE360
V.L.Sorrell, MD (@CASEfromASE EIC)@VLSorrellImages
#JADEL New in @CASEfromASE Some CASE reports are able to change clinical practice through their educational message: doi.org/10.1016/j.caseโฆ Check out this 52yo woman with embolic stroke from unknown source. Remember, not all shunts are PFOs. ๐๐คช๐ #NowInScopus @ASE360
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1/14
Why can't you use direct oral anticoagulants (DOACs) in patients with mechanical valves (MVs)?
DOACs have been one of the most important advances in my career. And yet, the presence of a MV is one of the few contraindications.
The reason highlights the unique nature of thrombus formation in those with a MV and provides insights into the evolution of human hemostasis.
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#JADEL
New in @CASEfromASE
Some CASE reports are able to change clinical practice through their educational message:
doi.org/10.1016/j.caseโฆ
Check out this 52yo woman with embolic stroke from unknown source.
Remember, not all shunts are PFOs. ๐๐คช๐
#NowInScopus
@ASE360
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