Giles
gn94.bsky.social
Giles
@gn94.bsky.social
Acute Medicine SCF.
DIY, woodworking and gardening hobbyist.
Hoping to learn and laugh.
An interesting bit of etymology
December 14, 2024 at 4:29 PM
Reposted by Giles
🆕🔥Multicenter OL RCT
Compared with the GOLD strategy,PCT-guided antibiotic therapy significantly 🔽 rate of antibiotic prescription for patients with AECOPD, without negatively affecting treatment success rate #idsky @bradspellberg.bsky.social
www.clinicalmicrobiologyandinfection.com/article/S119...
December 9, 2024 at 12:00 PM
Reposted by Giles
When interpreting this trial, it is also important to consider the pre-specified adjusted analysis [OR 0.89 (95%CI 0.79 to 0.99)] as adjustment improves statistical efficiency. This article explains the benefits of adjustment quite well. #emimcc jamanetwork.com/journals/jam...
December 1, 2024 at 4:36 AM
Reposted by Giles
Skytorial: Piptazo vs Cefepime 😁

Recently this JAMA-IM paper correlating piptazo with mortality has gained a weird amount of attention

(It's been out for months so it's not really new)

This one of the most methodologically horrific papers I've ever seen

Lets talk real quick about the paper...
November 26, 2024 at 1:30 PM
Reposted by Giles
Like many others, I feel very strongly about this.

@ilovepathology.bsky.social, chair of NCEPOD, expresses appropriate concerns about how we miss far too often the opportunities to discuss end of life care.

Report by Matthew Limb in the @bmj.com.

#EOLC
#PalliativeCare
#ChoosingWisely
#MedSky
November 23, 2024 at 11:17 AM
Reposted by Giles
First paper to share here

Delightful to have been part of the all new UK guidelines on the diagnosis of and management of eosinophilia!

www.journalofinfection.com/article/S016...
UK guidelines for the investigation and management of eosinophilia in returning travellers and migrants
Eosinophilia is a common finding in returning travellers, migrants and other travelling groups. In this setting it often indicates an underlying helminth infection. Infections associated with eosinoph...
www.journalofinfection.com
November 12, 2024 at 10:51 PM
Reposted by Giles
You've probably heard that Bicarbonate has to turn into CO2 to raise the pH.

“Don’t give bicarb if you can’t increase ventilation.” But why?!

How much CO2 is there in an amp of sodium bicarbonate? Hos much does it raise pH? And how long does it last?

A 🧵 all about our ICU frenemy NaHCO3

1/
November 19, 2024 at 1:46 PM
Reposted by Giles
Dexmedetomidine is used quite a lot.
However, it’s not that benign an agent.

Single centre observational study finds 15% of patients on Dexmed have a fever of >38.5.

#emimcc

pubmed.ncbi.nlm.nih.gov/33813941/
pubmed.ncbi.nlm.nih.gov
November 19, 2024 at 11:17 PM
Reposted by Giles
A little thread about chronic subdural haematoma - a condition that impacts primary care, non-neurosurgical hospitals, anaesthetists, physicians and some people even need neurosurgery. Some new guidelines are out - led by Dan Stubbs and Ben Davies #Ansky #GeriSky #SDM #EMSky 1/
Clinical practice guidelines for the care of patients with a chronic subdural haematoma: multidisciplinary recommendations from presentation to recovery
A chronic subdural haematoma (cSDH) is an encapsulated collection of fluid and blood degradation products in the subdural space. It is increasingly common, affecting older people and those living w...
www.tandfonline.com
November 18, 2024 at 10:06 PM
Reposted by Giles
Autologous transplantation of P63+ lung progenitor cells in patients with bronchiectasis: A randomized, single-blind, controlled trial: Cell Reports Medicine www.cell.com/cell-reports...
Autologous transplantation of P63+ lung progenitor cells in patients with bronchiectasis: A randomized, single-blind, controlled trial
Yan et al. demonstrate that autologous P63+ progenitor cell transplantation enhances lung gas exchange function, quality of life, CT imaging outcomes, and bronchiectasis severity scores in patients wi...
www.cell.com
November 19, 2024 at 4:36 PM
Reposted by Giles
Honey, stop what you're doing, new hyponatremia research just dropped!

What's it say?

It looks like slow correction is associated with worse outcomes, like death and length of stay!

Was it just a small study?

No, it was a meta-analysis of almost 12,000 patients!

jamanetwork.com/journals/jam...
Correction Rates and Clinical Outcomes in Hospitalized Adults With Severe Hyponatremia
This systematic review and meta-analysis evaluates the association of sodium correction rates with mortality among hospitalized adults with severe hyponatremia.
jamanetwork.com
November 19, 2024 at 4:51 AM
32 minutes to drive 4 miles 😔
November 19, 2024 at 8:43 AM
Out of curiosity, anyone know why ESC says to wait for more safety data on acetazolamide IV for decompensated heart failure?

AKI and potassium not an issue in ADVOR.
November 14, 2024 at 12:13 PM
A wall of interesting geopolitics, medical research and teaching, and general non-partisan silliness?

Reminds me of something…
November 14, 2024 at 12:04 PM
Anti-drug antibodies against adalimumab are called HAHA (human anti-human antibodies). No laughing matter!
September 1, 2024 at 7:53 AM