As a pulmonologist I am absolutely here for canary sized hyperbaric chambers. I do wish they would have had respirators for the workers actively getting an interstitial lung disease while down there, though. 😥🫁 #Medsky #Pulmsky

So now we've just rebranded the place that everyone knew had the best fountain cokes in the county as having a "heavy" coke machine. I don't blame this on Gen Z, it was just a normal thing. share.google/icsEvCG355Df... And for the record, for my town it was Mr. Happy Burger's, no question.

With Cigna and Aetna beginning to use AI to automatically reduce payments and deny care (without reviewing documentation) starting October 1st, I wonder how long it will take for a "Little Bobby 'Drop' Tables" event to occur. #Medsky #XKCD #IYKYK

The word “autism” was first used to describe behavioral differences in children in 1911 but autism has been documented using available records going back to the 1700s (definitively) and further. Acetaminophen (Tylenol, paracetamol) was discovered in 1878 and first sold in the United States in 1950.

Paracetamol (Tylenol) does not cause autism, and it is a source of great dismay that autism researchers and Autistic advocates still have to spend so much time battling misinformation. Research on causes of autism systematically fails to control for the existence and behaviour of Autistic parents.

Ask your insurance if you Koalify...

Hey #Medsky and #IDsky, a friend and colleague is moving to a job in Florida. Sad for us, but happy for them. Please help me out with some suggestions on a textbook on tropical and/or vaccine preventable diseases (for the obvious joke and/or something genuinely helpful) as a going away present.

ICU #Hemodynamics: This scientific statement from the American Heart Association was published before DanGer Shock (PMID: 38587239) and provided a framework about how to escalate/de-escalate temporary mechanical circulatory support (tMCS) in cardiogenic shock (CS):

So I decided to take the histamine / #SARSCOV2 / #COVID19 literature for a ride after the astelazine nasal spray randomized trial that showed that application of the spray for 3 times a day may cut the risk of COVID19 PCR confirmed infection by 71% jamanetwork.com/journals/jam...

Hey @ama-assn.org why do you refuse to stand up against charlatans and snake oil salesmen who are set on sending us back to the pre-Semmelweis era? Growing a spine would actually represent physicians and patients. I would hurry too, before we all die of a disease as preventable as ignorance. #Medsky

I love college football. Less than 15 seconds into the Auburn commentary and they have already enraged every alum by claiming the "war eagle" is only a 25 to tradition. My wife went back and listened to it 3 times bc she didn't believe it. Do better @espn.com #Auburn #WarEagle #Espnfail

Congrats to @thebeths.bsky.social with a banger of a new 🎵 album! Straight Line was a Lie will light up your stereo and your day. Do you like indie rock? If you've not heard of them (yet), I'm not sure how I'd missed them either. Best listened to at high volume!!! 🤘

Glad to see folks actually digging into this and dispelling myths with science. Correlation is not (necessarily) causation. Once again, it's probably mostly -if not completely- genetics. #Neurodiversity #Autres

Acetaminophen/Tylenol use during pregnancy was not associated with children’s risk of autism, ADHD, or intellectual disability in sibling control analysis. This suggests associations observed in other, less rigorous analyses may have been attributable to familial confounding (aka erroneous finding):

I've got to say, @missmargoprice.bsky.social may have the best #country music album of the year. Fantastic work and what's a more timely single for surviving 2025 in America? 🎵 youtu.be/uyhzsMWC4sw?... 🎶

Doctors urge public to get vaccinated ahead of respiratory virus season

About this Florida vaccine story: When they were little - 1 yr and 3 1/2 - my two older boys, who’d had all their shots, got whooping cough. We asked their pediatrician what would’ve happened if they hadn’t been vaccinated. “Oh, they’d have died.”

The U.S. Secretary of Energy does not know that electricity is energy. I'm glad we've gotten rid of DEI programs and are now giving America the leadership it deserves.

It looks like about an ARR of 2.2% with semaglutide (hospitalization or death) and a NNT of 45, compared to control/sitagliptin.

I have to say, the official return of college football is a welcome diversion from <gestures broadly>.

Fantastic case in @journal_CHEST of an 18 yo who sustained a 40-ft fall leading to traumatic hemorrhagic pneumatoceles and respiratory arrest. Patient was treated with REBOA, parallel-circuit VV-ECMO, and systemic isoflurane sedation; orthopedic fixation was performed on VV-ECMO

Along with everything that's led up to this point, this does not bode well for science in the US. Whatever vaccine and/or autism disinformation JFK Jr is about to release must be more vile than anyone could have had nightmares about.

Dearest Martha, The National Guard stand solemn watch at the Krispy Kreme tonight. I cannot tell if they defend the people from the donuts, or the donuts from the people. Powdered sugar hangs in the air like cannon smoke. Jensen took a hot coffee to the face, he may never recover. Yours in glaze,

I feel like people don't see that the Cracker Barrel thing is an extremely watered down version of people not wanting the Confederate monuments to go. People are changing "Southern" culture. Has private equity made it worse and alienated the customer base? Sure, but this part really isn't news.

Dear journalists: The President has not fired Lisa Cook. The President is *trying* to illegally fire her. Your words shape people’s reality. Please be accurate in your reporting.

Walz: "It boggles my damn mind that in the midst of a military takeover of our cities, the flaunting of the rule of law, that the press finds the need to talk about, 'Oh, there's a division in the Dem Party.' There's a division in my damn house & we're still married and things are good. That's life"

Are people with “young COPD” (airway obstruction and a 10 pack-year smoking history or respiratory symptoms in people under 50) at increased risk of hospitalization or premature death? A new study in NEJM Evidence addresses this question: eviden.cc/44JQGYU #MedSky #PulmSky

5 Questions to ask yourself after every patient encounter in the ICU. Outstanding advice and rules to live by from the late Dr JP Pryor. #SCCM2025

That 37% of people polled thought that "honest" could be used to describe Trump is an indictment of education and media in the US. Even if we generously say that a full 10% of people polled misheard and thought they said "Dishonest" that's still a QUARTER of the US. Propaganda is a heck of a drug.

29. LVOTO and stress-cardiomyopathy are quite common in Critical Care; more common than you think! Please use #pocus

Today, the physician dining area had a sign up that said that today was national fajita day, with a picture of a taco, and neither of those being served. I wish it was satire. #Medsky

🚨 COVID & vascular aging 🚨 CARTESIAN trial (2,300 people, 16 countries) shows: • ↑ arterial stiffness months after infection—even if mild • Effects strongest in women & long COVID • Adds ~5 yrs of vascular aging • Vaccination helps COVID isn’t a cold. The heart & vessels remember #MedSky #Covid

The Bureau of Labor Statistics data shows food prices have spiked, and wholesale prices on fresh and dry vegetables increased by nearly 40 percent last month — the biggest increase in the last three years. Why? Donald Trump‘s tariffs. Story: www.rollingstone.com/politics/pol...

If feeding the poor in your city has been outlawed, but giving weapons to the homeless has not; talk with your lawyer about simply arming them with sandwiches. How do you like the odds on that one @kenwhite.bsky.social ?

Despicable. There's nothing like an elected representative diminishing their office, state, and country at the same time. I'd call it ignorance, but he seems like he's probably intelligent enough for it to be purposeful.

This is a wild paper on the performance of warm/empathetic AI models in medical reasoning. This is the start of whatever we're calling a #Thread on Bluesky. A #Skeeterfall? A #SkeetShoot? A #Skeetitorial? arxiv.org/html/2507.21... #Medsky 1/x

I know there are more pressing issues in the US, but why have I never seen Cortland apples in a grocery store? They are one of the best and what we inevitably come home with on the rare occasion we go to an orchard. Do they need better PR? Are they harder to grow? Is "Big Honeycrisp" behind it?

BREAKING: Donald Trump has ordered the mobilization of the National Guard to Washington, D.C. in a MAJOR escalation. I am in Washington, D.C. I will be covering this all day as we get more information. Spread the word. open.substack.com/pub/aaronpar...

And I hope this will not just be called the pierogi revolution, but may it spark a true pierogi Renaissance in America :) One of the few things I miss about Gary, IN is being close enough to NW Indiana to attend Pierogi Fest.

I HAVE FINALLY FIGURED OUT THE RECIPE TO THE SALSA I'VE BEEN TRYING TO MAKE FOR NO JOKE 15+ YEARS!!! YES!!!

While I'll be the first to say that the AI healthcare stuff I have seen (so far) is abysmal, unhelpful, and more error riddled than a press release from our current HHS admin, this clickbait article actually needs better context. #Medsky futurism.com/neoscope/goo...

Am I WRONG About COVID vaccines?? A New study published through #JAMA was highlighted in #MedPage Today. The headline was that the #COVID-19 vaccines were less effective than previously thought and didn’t need to be given to anyone under 60. I was curious, until I saw who the authors were.

Jesse Welles is a national treasure, pumping out timely folk songs on a Woody Guthrie level.

Before anyone asks, here's a version with alt text:

Autism is not due to mercury "toxicity" for a zillion reasons, one of which is that mercury poisoning doesn’t even LOOK like autism: Mercury poisoning causes smaller heads, and autistic people tend to have GINORMOUS noggins. #VaccinesSaveLives and have nothing to do with autism. #neurodiversity

IDK, maybe it's me, but a hippie in overalls, DJ biceps, and a grooving black due tearing up the guitar playing pleasant but generic indie pop should not have the word "Goth" in the band name lol. I knew a lot of goth kids in HS, and man, this ain't them. #LiveMusic 🎵