Roger Struble, MD, MPH
@jazzscrubs.bsky.social
Pulmonary & Critical Care Physician | Iowa City | Midwestern Dad Vibes | Educator | Building my Research Skills, T32 | Sharing the human experience, knowledge seeker.
How was this affected by the amount of intubated patient days? How did the level of CT scans compare? In the MICU, there may be more comfortability with ultrasound. Any thoughts on ways to control for this?
April 8, 2025 at 2:35 AM
How was this affected by the amount of intubated patient days? How did the level of CT scans compare? In the MICU, there may be more comfortability with ultrasound. Any thoughts on ways to control for this?
Just had a case of Bradykinin mediated angioedema this week in which we had to perform nasotracheal intubation. Was given steroids, epinephrine, and diphenhydramine with no response. In hindsight should have intubated earlier
March 13, 2025 at 4:54 PM
Just had a case of Bradykinin mediated angioedema this week in which we had to perform nasotracheal intubation. Was given steroids, epinephrine, and diphenhydramine with no response. In hindsight should have intubated earlier
We have resorted to heavy bribes. My daughter ate a cupcake today. Not proud of it, but so hard to clean poopy undies after a long day at the hospital.
January 11, 2025 at 2:11 AM
We have resorted to heavy bribes. My daughter ate a cupcake today. Not proud of it, but so hard to clean poopy undies after a long day at the hospital.
Mama is at work so I’m stuck on Daddy duty. Please coffee, give me strength
December 7, 2024 at 2:02 PM
Mama is at work so I’m stuck on Daddy duty. Please coffee, give me strength
Thoughts on adding fludrocortisone? Could it help in hyponatremia? APROCCHSS dosing may not hit detectable levels, and hydrocortisone offers some mineralocorticoid activity. But latest meta-analysis hints at benefits w/ no clear harms—but big RCT data is still missing. 🤔 What’s your take?
December 6, 2024 at 3:25 PM
Thoughts on adding fludrocortisone? Could it help in hyponatremia? APROCCHSS dosing may not hit detectable levels, and hydrocortisone offers some mineralocorticoid activity. But latest meta-analysis hints at benefits w/ no clear harms—but big RCT data is still missing. 🤔 What’s your take?
Inspiring! Excited to read the review
December 6, 2024 at 2:40 AM
Inspiring! Excited to read the review
This is great, thank you. Would love to join the list if there is still room.
December 2, 2024 at 4:46 PM
This is great, thank you. Would love to join the list if there is still room.
The hospital is full of tough calls. For stable, improving, immunocompetent, gram-negative bacteremia (not Staph aureus), 7 days of antibiotics is likely enough. Safe. Effective. Gut-friendly. More patient and system-friendly. 🦠🚫
December 2, 2024 at 4:14 PM
The hospital is full of tough calls. For stable, improving, immunocompetent, gram-negative bacteremia (not Staph aureus), 7 days of antibiotics is likely enough. Safe. Effective. Gut-friendly. More patient and system-friendly. 🦠🚫
Real-world reality check: 23% of "7-day" patients got extra antibiotics anyway (vs. 11% in the 14-day group). Docs often extended treatment based on clinical judgment. This trial supports shorter intended courses, not rigid rules. ⚖️
December 2, 2024 at 4:14 PM
Real-world reality check: 23% of "7-day" patients got extra antibiotics anyway (vs. 11% in the 14-day group). Docs often extended treatment based on clinical judgment. This trial supports shorter intended courses, not rigid rules. ⚖️
Before you start ordering 7-day courses for everyone, here’s the fine print:
Staph aureus? Excluded.
Indwelling devices? Excluded.
Severely immunocompromised? Yep, excluded.
This is for gram-negative bacteremia without major complications. Keep your judgment hat on. 🧠👨⚕️
Staph aureus? Excluded.
Indwelling devices? Excluded.
Severely immunocompromised? Yep, excluded.
This is for gram-negative bacteremia without major complications. Keep your judgment hat on. 🧠👨⚕️
December 2, 2024 at 4:14 PM
Before you start ordering 7-day courses for everyone, here’s the fine print:
Staph aureus? Excluded.
Indwelling devices? Excluded.
Severely immunocompromised? Yep, excluded.
This is for gram-negative bacteremia without major complications. Keep your judgment hat on. 🧠👨⚕️
Staph aureus? Excluded.
Indwelling devices? Excluded.
Severely immunocompromised? Yep, excluded.
This is for gram-negative bacteremia without major complications. Keep your judgment hat on. 🧠👨⚕️
The numbers:
Mortality: 14.5% (7 days) vs. 16.1% (14 days)
C. diff rates? Same.
No harm detected in most subgroups, though confidence intervals were wide in some (e.g., gram-positive infections, high frailty scores). 🤔
Mortality: 14.5% (7 days) vs. 16.1% (14 days)
C. diff rates? Same.
No harm detected in most subgroups, though confidence intervals were wide in some (e.g., gram-positive infections, high frailty scores). 🤔
December 2, 2024 at 4:14 PM
The numbers:
Mortality: 14.5% (7 days) vs. 16.1% (14 days)
C. diff rates? Same.
No harm detected in most subgroups, though confidence intervals were wide in some (e.g., gram-positive infections, high frailty scores). 🤔
Mortality: 14.5% (7 days) vs. 16.1% (14 days)
C. diff rates? Same.
No harm detected in most subgroups, though confidence intervals were wide in some (e.g., gram-positive infections, high frailty scores). 🤔
First, the basics: 3,608 patients, 74 hospitals, 7 countries, 9 years. This wasn’t a quick study—it was a global, multicenter marathon to settle the “7 vs. 14 days” debate for bloodstream infections. 🏥🌍
December 2, 2024 at 4:14 PM
First, the basics: 3,608 patients, 74 hospitals, 7 countries, 9 years. This wasn’t a quick study—it was a global, multicenter marathon to settle the “7 vs. 14 days” debate for bloodstream infections. 🏥🌍
Nothing hits like a hot coffee on a crisp Iowa morning—13 degrees, a fire crackling, and the perfect mug from @BluebirdDiner.
November 30, 2024 at 1:56 PM
Nothing hits like a hot coffee on a crisp Iowa morning—13 degrees, a fire crackling, and the perfect mug from @BluebirdDiner.