. Frederik H. Verbrugge says, pulse pressure is cheap man’s 🦢 Great talk on #heartfailure - #HR2025 Hospitalist side

Hospitalist and Resuscitationist 2025 (#HR25) conference blended cutting edge physiology, new evidence, and a ton of expert wisdom. It was incredible. Here were 10 of my top learnings 👇

Well designed RCT shows patients randomized to an exercise program had substantially improved survival after adjuvant chemotherapy for colon cancer. - 5 yr disease-free survival 80.3% vs 73.9% (HR 0.72) - 8 yr overall survival 90.3% vs 83.2% (HR 0.63) This is groundbreaking! 1/

ACLS has it wrong... if you are reaching for adenosine, start with 12mg. In this retrospective review of >11,000 patients across 1350 EMS agencies, they compared 6mg versus 12mg of adenosine for PSVT, they found: -48% of those in the 6mg group required additional doses of

NephroPOCUS Ashley Miller So for example a DBP of 40 mmHg with HR 115 is more likely to have a low SVR than a person with a DBP of 40 mmHg with HR 50, which probably has a higher SVR

What a teaching point. Never realized it but makes ton of sense. Appreciate it.

Big win for Arizona and the West: the reckless proposal to sell off millions of acres of public lands is OUT. I’ve fought this from the start because public lands belong to all Americans, not billionaires and corporate developers. We must protect them for future generations.

3. Here’s the key equation: 🧮 Max urine volume = Total daily osmoles / Minimum urine osmolality With only 100 mosmol/day of solute and dilution to 50 mosmol/kg: ➡️ 100 / 50 = 2 litres/day max water clearance. Drink more than that? Water is retained → sodium falls.

I’m sharing an actual recent peer-to-peer call that shows what physicians and patients face when trying to get a surgery approved. This call felt as absurd as it sounds. The peer-to-peer call was to advocate for surgery to prevent and treat lymphedema for a patient with breast

We have to be our own plumbers, electricians, contractors, dentists, phlebotomists, and even ultrasound techs up here! 大西卓哉 （JAXA宇宙飛行士）Takuya Onishi and I recently did a routine venous thromboembolism (VTE) scan of the jugular vein. While in microgravity aboard the International Space Station, our blood

Rajiv Ashley Miller Philippe Rola Eduardo R Argaiz NephroPOCUS 3/3 followed by a clinician brainstem reflex to continue a prescription of more fluids that temporarily improve MAP at the expense of further uncoupling of the circulation and worsening tissue perfusion. Rinse, repeat. Patient dies despite “we did everything we could”.

The career trap no one warns physicians about: evaluating your first job and partnership opportunity. Most doctors will sign a contract without understanding the business you’re walking into. Here’s how to avoid getting screwed:

Ever wonder why bruises change color? Red → Blue → Green → Yellow → Brown That’s hemoglobin breaking down: 🔴 Oxy Hb → 🔵 Deoxy Hb → 🟢 Biliverdin → 🟡 Bilirubin → 🟤 Hemosiderin Your skin becomes a living chemistry timeline. #Hematology #MedEd

Story time: I went to DC in 2019 to try to meet with Congress members about No Surprises Act Not seeing patients for a couple days was a huge sacrifice but I thought well worth it given what was at stake: the future of private practice I had a PAC check from my specialty to

One of the biggest problems with Medicaid cuts is many people who are on Medicaid don’t realize that they are! 24/51 programs including PAdon’t have Medicaid in the name. This would be a great point to make on #ThePitt!

Honestly if the FDA wanted to do something beneficial with acetaminophen they would outlaw combination products with it, limit package size, & mandate packaging in blister packs. They did this in the UK and it reduced deaths from Tylenol overdose by 22% pmc.ncbi.nlm.nih.gov/articles/PMC31…

This systematic review included 65 studies & 17,008 patients with #sepsis. The occurence rate of each one of the three #echocardiographic phenotypes, namely left ventricular systolic dysfunction (LVSD), LV diastolic dysfunction (LVDD), & RV dysfunction (RVD) peaked at 48h:

One picture, enough said. This is why 👨‍⚕️👩‍⚕️ "feelings" about congestion don’t cut it. #POCUS #Nephpearls #VExUS #FOAMed

This is a transparently anti-vax strategy: - taking a safe existing product off the market - delay for years until new monovalent vaccines are approved. (And probably try to avoid approving them) - meanwhile vaccination rates plummet & measles cases skyrocket 1/

Post N° 3: “Why test higher MAP targets in Tier 2?” Large trials (SEPSISPAM, 65) found no clear benefit of higher MAP targets — and the recent Optpess trial even signaled harm at higher targets. (1/n)