I SET YOU ALL UP FOR AN INFLATION JOKE AND AM DISAPPOINTED IN YOUR FAILURE

A 31-year-old woman presented with 10 days of fever, sinus pressure, cough, nausea, and vomiting. Three episodes of similar symptoms, as well as night sweats, fatigue, and weight loss, had occurred in the previous 5 months. Read the full case details: nej.md/4sbcTbS #MedSky #IDSky #Immunology

posterior view of the skull pretty creepy

Bruising on the back of the hand is so common in older adults that John Mulaney used to have a joke about it in his touring set in 2024. It is not a smoking gun for a peripheral IV no matter how badly journalists want it to be.

It's not too late to get your flu shot. Flu circulates year round but more intensely during flu season. For N. hemisphere: Onset: October–November Peak: December–February (most often January) Decline: March Tail end: April–May (occasionally later) This is why we give shots until the end of February

It is very important to me that we do not tell apartment complexes that they need fast chargers for EVs. They need level 2 chargers. Not more than is used by a dryer or electric range. When you're charging overnight, you do not need crazy voltage.

Gluten free but gluing the 11th will cost you.

Rapid response www.bmj.com/content/386/... on randomization and allocation leading to eventual retraction from the @bmj.com www.bmj.com/content/391/... Intraosseous vs IV access trial #EMIMCC #EpiSky

had a dream where it was the end of the semester and i had studied very hard for all my classes. i took each final exam and finished on time. i did really well and was rewarded for my diligence with passing grades and honors. pretty nice dream. glad i had it. everyone fully clothed, too.

Whoa www.nejm.org/doi/full/10....

Did you know that from tomorrow, Qualtrics is offering synthetic panels (AI-generated participants)? Follow me down a rabbit hole I'm calling "doing science is tough and I'm so busy, can't we just make up participants?"

Do you ever wonder which patients are accessing their patient portal during their hospitalization? Turns out, not all patients use the portal equally: health disparities have been noted in inpatient portal use. Read more: https://doi.org/10.1002/jhm.70093 #VisualAbstract by Shaheen Fatima

Complex regional pain syndrome (CRPS) is characterized by substantial pain in a distal limb. Approximately 90% of cases are triggered by physical limb trauma; the condition typically commences immediately to less than 1 month after the inciting event. Learn more: nej.md/3MSMW0n #MedSky

1st, I review the resident note: it’s disorganized but OK 2nd, I review the med list. Every drug is perfectly dosed, timed, and routed. Totally optimized, tidy med list.

I give the NEJM a lot of guff about their social media posts, but this is exactly how you should share important articles.

You can do this right now: Think of a person who wrote a paper you love, whose work influenced or helped you, or has made your professional life better. Search up their email address. Shoot them a quick email of thanks. It means so, so much. This is a rough time of year, share some joy.

Yeah I have a question can I have 20% of my screen back so I can RTFA

I am a pediatric ICU physician. I am filled with dread knowing viruses and bacteria will provide the education to families who don't vaccinate their children. And the cost will be dear.

A 70-year-old man presented with several hours of shortness of breath and a slow heart rate that had been detected by the ballistocardiographic monitor in his commercial mattress. Read the full case details: nej.md/4iyuh5K #MedSky #CardioSky

“DAPT was found to not NOT have an inferiority complex towards monotherapy…”

Bad framing: ACIP voted to scrap the universal hepatitis B vaccine recommendation for newborns. Accurate framing: Anti-vax conspiracy theorists appointed to ACIP by Robert Kennedy Jr., who made a fortune as an anti-vax profiteer, voted to expose babies to a preventable, incurable, deadly illness.

If you use AI chat agents, the single greatest productivity hack is to disable any “memory” features.

This is a really cool and important discussion. I certainly understand the arguments for pass/fail, but thought the point regarding the “shadow economy” of research made by the proponents of tiered grading was pretty compelling.

A.fib patients often have Atrial flutter and/or Atrial tachycardia as well. This can be confusing! Use this direct link for a simple explanation for patients, to assist with treatment discussions: www.youtube.com/watch?v=oy9g...

there's a reason we have less chronic hepatitis B infections in the USA -

Prasad just got a 95% BSA 3rd degree burn in the NEJM 🍿

Hear more from Benjamin in “Doctor with a Capital D,” episode 3.6 of the Not Otherwise Specified podcast, hosted by NEJM National Correspondent Dr. Lisa Rosenbaum: nej.md/4og9ght Listen to past episodes and subscribe to the podcast: nej.md/NOS

Oncologists, B7 beware: dermatologists from #OSUWexMed sharing a call to action for oncologists to ask patients about biotin use for hair regrowth in interpretation of TSH, PSA, estradiol, testosterone, and more. Beyond lab interference, limited evidence for efficacy. ascopubs.org/doi/10.1200/...

Yeah - imo people fear/invoke the theoretical potential of "tiring out" way too much. Even if the person doesn't code from acidemia during RSI, intubation/mechanical ventilation have real harms, and we can't always do better than the patient themselves in these cases.

how i begin my Conclusion

Neither Montana nor California have legalized in-app gambling and the fact that those two very different states agree on this should be a signal to everywhere else.

Patient with cirrhosis and INR of 3 needs a procedure Please step away from the FFP EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures) Plt & fibrinogen are more controversial Discussion emcrit.org/ibcc/cirrhos... #EMIMCC

Do your parent friends know there's a vaccine that can prevent one of the 10 most common types of cancer (both incidence and mortality) in the world?

The Australian Govt made the HPV vax available for free to girls from age 12 in 2007, extended to boys in 2013. #VaccinationsSaveLives

A reminder: Early CCY after ERCP 🤔Although guidelines rec: Early CCY (same admission), only done about half the time 🤔Study: ACG Scientific Meeting 😒Biliary comps in 23% delayed, vs 0.8% early ccy 🔑: Risk NOT mitigated by sphincterotomy or stenting. Carpe Diem: #gisky #medsky #imsky

the last 24 hours on X, summed up:

My new favorite kind of meme is "here are detailed instructions on how to turn off AI". 🔨

HFimpEF is best treated with allergen avoidance, antihistamines, and nasal corticosteroids

Part 1: Oh no, red exclamation mark, acetaminophen level must be high. Click.

I am prepared to vote for anybody who will stop this

It’s a special time of year, when the leaves argue with the sky and the squirrels are all fat and anxious

Please, call me Orfor.

If they were shorter they would not touch the ground

Happy There Is A Circulatory System Walking Through The Kitchen Day to all who celebrate.

Sunday running chronicles: Unseasonably warm, but still getting dark out at 4:30 PM. The smell of fallen leaves and rotting hay makes me think not all decay is bad.

🚲⚠️ Look out, CAR T, there's another transportation-named cancer treatment class in town! ⚠️🚲 First-in-human trial of bicycle-drug conjugates (BDCs) hit JCO this week. So what are they, and how are they different than antibody-drug conjugates (ADCs)? #OncSky #MedSky

Only Jason Isbell can casually drop "diphenhydramine" into a song and take nothing away from the melody or poetry