Will Preston
@willpreston.bsky.social
Hospitalist in Bronx NY
Interests include clinical epidemiology and med ed.
Shasta connoisseur.
Interests include clinical epidemiology and med ed.
Shasta connoisseur.
Reposted by Will Preston
Don DeLillo punching a wall in anger that he didn’t come up with this dialogue bsky.app/profile/jami...
Border Patrol agent Lairmore testifies that he was not injured by the sandwich, but he felt the impact through his ballistic vest.
The sandwich came apart and "kind of exploded" on his chest upon impact, he says.
"I could smell the onions and mustard."
The sandwich came apart and "kind of exploded" on his chest upon impact, he says.
"I could smell the onions and mustard."
November 4, 2025 at 3:50 PM
Don DeLillo punching a wall in anger that he didn’t come up with this dialogue bsky.app/profile/jami...
Reposted by Will Preston
1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome Part ✌️
Let’s dive into treatment 🌊!
1️⃣ Vasoconstrictors
2️⃣ Albumin
3️⃣ Diuretics
Goal: raise MAP by 10-15 ‼️
🖥️: www.coreimpodcast.com/2025/10/22/h...
Let’s dive into treatment 🌊!
1️⃣ Vasoconstrictors
2️⃣ Albumin
3️⃣ Diuretics
Goal: raise MAP by 10-15 ‼️
🖥️: www.coreimpodcast.com/2025/10/22/h...
October 22, 2025 at 11:02 AM
1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome Part ✌️
Let’s dive into treatment 🌊!
1️⃣ Vasoconstrictors
2️⃣ Albumin
3️⃣ Diuretics
Goal: raise MAP by 10-15 ‼️
🖥️: www.coreimpodcast.com/2025/10/22/h...
Let’s dive into treatment 🌊!
1️⃣ Vasoconstrictors
2️⃣ Albumin
3️⃣ Diuretics
Goal: raise MAP by 10-15 ‼️
🖥️: www.coreimpodcast.com/2025/10/22/h...
5 pearls is such a great series because even when it’s covering a topic I think I know well, there’s always something important I learn — many such moments in this excellent episode.
1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome (HRS) part 1️⃣
AKI + portal HTN 🟰hepatorenal syndrome
🖥️: www.coreimpodcast.com/2025/10/15/h...
AKI + portal HTN 🟰hepatorenal syndrome
🖥️: www.coreimpodcast.com/2025/10/15/h...
October 15, 2025 at 6:12 PM
5 pearls is such a great series because even when it’s covering a topic I think I know well, there’s always something important I learn — many such moments in this excellent episode.
Reposted by Will Preston
What the DOTS trial of Staph bacteremia tells us:
• Dalbavancin d1 and d8 vs daily IVs for WEEKS
• No left-sided IE/CNS/prosthetics
• Dalba not superior by DOOR endpoint, but similar clinical outcomes.
Big implications for inpt care. More here! #IDSky tinyurl.com/3hjzkt96
• Dalbavancin d1 and d8 vs daily IVs for WEEKS
• No left-sided IE/CNS/prosthetics
• Dalba not superior by DOOR endpoint, but similar clinical outcomes.
Big implications for inpt care. More here! #IDSky tinyurl.com/3hjzkt96
DOTS: Optimism Around a “Negative” Dalbavancin Trial
The DOTS randomized clinical trial of dalbavancin versus standard-of-care for Staph aureus bacteremia (SAB) just landed in JAMA, where it undoubtedly will be featured in numerous ID, hospitalist, and ...
tinyurl.com
October 10, 2025 at 10:55 AM
What the DOTS trial of Staph bacteremia tells us:
• Dalbavancin d1 and d8 vs daily IVs for WEEKS
• No left-sided IE/CNS/prosthetics
• Dalba not superior by DOOR endpoint, but similar clinical outcomes.
Big implications for inpt care. More here! #IDSky tinyurl.com/3hjzkt96
• Dalbavancin d1 and d8 vs daily IVs for WEEKS
• No left-sided IE/CNS/prosthetics
• Dalba not superior by DOOR endpoint, but similar clinical outcomes.
Big implications for inpt care. More here! #IDSky tinyurl.com/3hjzkt96
Reposted by Will Preston
Case Record of the MGH: A 36-year-old man was admitted because of fever, hypoxemia, and bacteremia. Imaging revealed pulmonary opacities, thickening of the duodenal wall, and a thrombus in the right renal vein. A diagnosis was made. Full case details: nej.md/3KYBaAE
#MedSky
#MedSky
October 9, 2025 at 4:02 PM
Case Record of the MGH: A 36-year-old man was admitted because of fever, hypoxemia, and bacteremia. Imaging revealed pulmonary opacities, thickening of the duodenal wall, and a thrombus in the right renal vein. A diagnosis was made. Full case details: nej.md/3KYBaAE
#MedSky
#MedSky
The NEJM case records this week is an all timer with Dr Dhaliwal. They do a Watson on jeopardy! style challenge where his answers are compared to an AI’s - should definitely read for yourself but just want to be the first to say humanity’s still got it baby!
October 8, 2025 at 7:20 PM
The NEJM case records this week is an all timer with Dr Dhaliwal. They do a Watson on jeopardy! style challenge where his answers are compared to an AI’s - should definitely read for yourself but just want to be the first to say humanity’s still got it baby!
Reposted by Will Preston
5/6🧵Unauthorized immigrants contribute billions to the U.S. health system — more than they receive in care.
In 2017 alone, net contributions totaled:
$20.8B to Medicare
$21.3B to Medicaid
$14.7B to private insurance
They are net funders, not burdens.
In 2017 alone, net contributions totaled:
$20.8B to Medicare
$21.3B to Medicaid
$14.7B to private insurance
They are net funders, not burdens.
October 6, 2025 at 3:06 PM
5/6🧵Unauthorized immigrants contribute billions to the U.S. health system — more than they receive in care.
In 2017 alone, net contributions totaled:
$20.8B to Medicare
$21.3B to Medicaid
$14.7B to private insurance
They are net funders, not burdens.
In 2017 alone, net contributions totaled:
$20.8B to Medicare
$21.3B to Medicaid
$14.7B to private insurance
They are net funders, not burdens.
Almost like people want socialized healthcare! Best we can do is cut the largest public insurance, replace vaccines with crank science, gut our research institutions, and prevent any new HCWs from coming here but here’s an AI video of our demented president saying he’ll make you live forever.
Trump tonight appears to have pushed the false "medbed" conspiracy theory, which has spread in the far-right internet over the years. www.yahoo.com/news/qanon-c...
September 28, 2025 at 12:03 PM
Almost like people want socialized healthcare! Best we can do is cut the largest public insurance, replace vaccines with crank science, gut our research institutions, and prevent any new HCWs from coming here but here’s an AI video of our demented president saying he’ll make you live forever.
Reposted by Will Preston
Trump: don’t take acepitoemponoene
RFK Jr: *moth crawls out of mouth*
A nude man is in the background, only referred to as “the colonel”
Person watching on tv: well if they say so
RFK Jr: *moth crawls out of mouth*
A nude man is in the background, only referred to as “the colonel”
Person watching on tv: well if they say so
September 23, 2025 at 12:44 AM
Trump: don’t take acepitoemponoene
RFK Jr: *moth crawls out of mouth*
A nude man is in the background, only referred to as “the colonel”
Person watching on tv: well if they say so
RFK Jr: *moth crawls out of mouth*
A nude man is in the background, only referred to as “the colonel”
Person watching on tv: well if they say so
I am loath to report the most parsimonious diagnosis is scurvy. I recommend continued palliation with poultices as seen here or perhaps cauterization of the most severe lesions, as well as an extra portion each of hardtack and grog for the remainder of his voyage.
August 25, 2025 at 1:47 AM
I am loath to report the most parsimonious diagnosis is scurvy. I recommend continued palliation with poultices as seen here or perhaps cauterization of the most severe lesions, as well as an extra portion each of hardtack and grog for the remainder of his voyage.
Reposted by Will Preston
Every hospital in the US had immediate access to expert toxicologists (via poison control).
Most hospitals *lack* access to inpatient addiction medicine services.
Structurally, we’re great at resus, but then we often fail at chronic tx of substance use disorders.
jamanetwork.com/journals/jam...
Most hospitals *lack* access to inpatient addiction medicine services.
Structurally, we’re great at resus, but then we often fail at chronic tx of substance use disorders.
jamanetwork.com/journals/jam...
Substance Use Disorder Program Availability in US Hospitals
This cross-sectional study examines differences in the delivery of different substance use disorder programs in safety-net hospitals vs non–safety-net hospitals across the US and evaluates whether the...
jamanetwork.com
August 24, 2025 at 6:13 PM
Every hospital in the US had immediate access to expert toxicologists (via poison control).
Most hospitals *lack* access to inpatient addiction medicine services.
Structurally, we’re great at resus, but then we often fail at chronic tx of substance use disorders.
jamanetwork.com/journals/jam...
Most hospitals *lack* access to inpatient addiction medicine services.
Structurally, we’re great at resus, but then we often fail at chronic tx of substance use disorders.
jamanetwork.com/journals/jam...
Reposted by Will Preston
This is correct. Any candidate cynically “triangulating” on trans kids is a non-starter, and now is the time to say so. There’s still so much time to advance candidates that DON’T suck.
I will never, ever vote for Gavin Newsom. Ever, under any circumstances. I don't care if he becomes the Dem nominee, he's still not getting my vote.
On a recent podcast Gavin Newsom tells Shawn Ryan how the Trans sports issue opened the door for him to change his mind on GAC for Trans Youth.
As someone who adored him since 2004 and voted for him 5 times, I can't wait for him to leave office.
There is no way I will be voting for him a 6th time.
As someone who adored him since 2004 and voted for him 5 times, I can't wait for him to leave office.
There is no way I will be voting for him a 6th time.
July 17, 2025 at 1:03 AM
This is correct. Any candidate cynically “triangulating” on trans kids is a non-starter, and now is the time to say so. There’s still so much time to advance candidates that DON’T suck.
As clinicians there is little we can do about radiology interpretations, but should try to stick to the diagnostic algorithms and avoid relying on hunches. Missed PE has <5% risk of recurrence and mortality which is probably less than major bleeding risk from cumulative years on an unnecessary DOAC.
August 20, 2025 at 8:44 PM
As clinicians there is little we can do about radiology interpretations, but should try to stick to the diagnostic algorithms and avoid relying on hunches. Missed PE has <5% risk of recurrence and mortality which is probably less than major bleeding risk from cumulative years on an unnecessary DOAC.
Writing up a case with my residents and shocked at what I'm learning about diagnosis of PE. PIOPED II the last RCT of CTA had a PPV of only 58% in the low risk group; more recent retrospective had 25% of all positive scans deemed false positive on expert review (including 16% of lobar PE).
Overdiagnosis of Pulmonary Embolism by Pulmonary CT Angiography | AJR
OBJECTIVE. The purpose of this study is to evaluate the rate of overdiagnosis of pulmonary embolism (PE) by pulmonary CT angiography (CTA) in a tertiary-care university hospital. MATERIALS AND METHODS...
ajronline.org
August 20, 2025 at 7:32 PM
Writing up a case with my residents and shocked at what I'm learning about diagnosis of PE. PIOPED II the last RCT of CTA had a PPV of only 58% in the low risk group; more recent retrospective had 25% of all positive scans deemed false positive on expert review (including 16% of lobar PE).
August 7, 2025 at 2:45 AM
I’ve never wanted be embroiled in online cancel culture and I really hate to say this as a fan, but last night at the NY Liberty game I didn’t feel John Turturro was clapping with adequate enthusiasm during the Big Ellie Stomp.
August 6, 2025 at 8:45 PM
I’ve never wanted be embroiled in online cancel culture and I really hate to say this as a fan, but last night at the NY Liberty game I didn’t feel John Turturro was clapping with adequate enthusiasm during the Big Ellie Stomp.
New hoofbeats let’s goooooo 😎🤙
1/ 🚨 NEW #Hoofbeats episode!
Let’s diagnose BOTH the patient and the clinician by figuring out the disease process and the cognitive processes that led us towards/away from it 🩺
🖥️: www.coreimpodcast.com/2025/07/21/d...
Let’s diagnose BOTH the patient and the clinician by figuring out the disease process and the cognitive processes that led us towards/away from it 🩺
🖥️: www.coreimpodcast.com/2025/07/21/d...
August 2, 2025 at 12:46 AM
New hoofbeats let’s goooooo 😎🤙
Reposted by Will Preston
Major innovation in medical education: the dyspnea pyramid is now the dyspnea rhombus
July 10, 2025 at 7:47 PM
Major innovation in medical education: the dyspnea pyramid is now the dyspnea rhombus
Reposted by Will Preston
You know things are bad when trauma surgeons are talking about Stoic philosophy.
Seriously, though, this is an interesting article. #EMIMCC
Seriously, though, this is an interesting article. #EMIMCC
July 7, 2025 at 3:53 PM
You know things are bad when trauma surgeons are talking about Stoic philosophy.
Seriously, though, this is an interesting article. #EMIMCC
Seriously, though, this is an interesting article. #EMIMCC
Reposted by Will Preston
1/ 🚨 NEW #5Pearls: Pleural Effusions 🌊
Did you know up to 30% of pleural effusions of have more than one etiology?
Let’s dive in!
🖥️: www.coreimpodcast.com/2025/07/09/p...
Sponsor: Oakstone CME
Featuring: @pulmpeeps.bsky.social
Did you know up to 30% of pleural effusions of have more than one etiology?
Let’s dive in!
🖥️: www.coreimpodcast.com/2025/07/09/p...
Sponsor: Oakstone CME
Featuring: @pulmpeeps.bsky.social
July 9, 2025 at 12:11 PM
1/ 🚨 NEW #5Pearls: Pleural Effusions 🌊
Did you know up to 30% of pleural effusions of have more than one etiology?
Let’s dive in!
🖥️: www.coreimpodcast.com/2025/07/09/p...
Sponsor: Oakstone CME
Featuring: @pulmpeeps.bsky.social
Did you know up to 30% of pleural effusions of have more than one etiology?
Let’s dive in!
🖥️: www.coreimpodcast.com/2025/07/09/p...
Sponsor: Oakstone CME
Featuring: @pulmpeeps.bsky.social
Reposted by Will Preston
1/ 🚨 NEW #BeyondJournalClub w/ @nejm.org: REDUCE-AMI
What is the long term benefit of beta blockers in patients with preserved EF following an MI?
🖥️: www.coreimpodcast.com/2025/06/25/b...
What is the long term benefit of beta blockers in patients with preserved EF following an MI?
🖥️: www.coreimpodcast.com/2025/06/25/b...
June 25, 2025 at 11:55 AM
1/ 🚨 NEW #BeyondJournalClub w/ @nejm.org: REDUCE-AMI
What is the long term benefit of beta blockers in patients with preserved EF following an MI?
🖥️: www.coreimpodcast.com/2025/06/25/b...
What is the long term benefit of beta blockers in patients with preserved EF following an MI?
🖥️: www.coreimpodcast.com/2025/06/25/b...
![From MD calc: “The model should be applied only after a history and physical suggests that venous thromboembolism is a diagnostic possibility. it should not be applied to all patients with chest pain or dyspnea or to all patients with leg pain or swelling. This is the most common mistake made. Also, never never do the D-dimer first [before history and physical exam]. The monster in the box is that the D-dimer is done first and is positive (as it is for many patients with non-VTE conditions)”](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:amklqog4avjkgvhzaqalqwhy/bafkreigzqtiwelw4ypqnvqcvs2v5rjsuqmvrtj27hllxwoci3i2x4bxxv4@jpeg)
Reposted by Will Preston
We set out to quantify U.S. academic contributions to medicines. The results stunned even us www.statnews.com/2025/06/06/u... via @statnews.com
Strongly encourage reading this First Opinion piece
Strongly encourage reading this First Opinion piece
We set out to quantify U.S. academic contributions to medicines. The results stunned even us
From 2020 to 2024, universities contributed patents underpinning 50% of FDA-approved drugs. 87% of those academic breakthroughs came from American institutions.
www.statnews.com
June 9, 2025 at 2:07 AM
We set out to quantify U.S. academic contributions to medicines. The results stunned even us www.statnews.com/2025/06/06/u... via @statnews.com
Strongly encourage reading this First Opinion piece
Strongly encourage reading this First Opinion piece