José Pedro Fernandes
@jpabreufernandes.bsky.social
MD | Internal medicine | Palliative care
Reposted by José Pedro Fernandes
epic case 🤯
man trying to eat a better diet asks ChatGPT how to eliminate chloride, it advises him to use *bromide* instead
he buys NaBromide from the internet
develops bromism (with psychosis)
key diagnostic clue = negative anion gap!
(more on low anion gap emcrit.org/ibcc/agma/#l...) #EMIMCC
man trying to eat a better diet asks ChatGPT how to eliminate chloride, it advises him to use *bromide* instead
he buys NaBromide from the internet
develops bromism (with psychosis)
key diagnostic clue = negative anion gap!
(more on low anion gap emcrit.org/ibcc/agma/#l...) #EMIMCC
August 11, 2025 at 5:17 PM
epic case 🤯
man trying to eat a better diet asks ChatGPT how to eliminate chloride, it advises him to use *bromide* instead
he buys NaBromide from the internet
develops bromism (with psychosis)
key diagnostic clue = negative anion gap!
(more on low anion gap emcrit.org/ibcc/agma/#l...) #EMIMCC
man trying to eat a better diet asks ChatGPT how to eliminate chloride, it advises him to use *bromide* instead
he buys NaBromide from the internet
develops bromism (with psychosis)
key diagnostic clue = negative anion gap!
(more on low anion gap emcrit.org/ibcc/agma/#l...) #EMIMCC
Reposted by José Pedro Fernandes
This ridiculous woman has migrated to Portugal from the UK because immigration is "wreaking demographic havoc" and "watering down British culture".
A 68-year-old. Plus her family. Doesn't speak a word of Portuguese. Enjoys tax breaks. Talks about the Portuguese like they're kind little savages.
A 68-year-old. Plus her family. Doesn't speak a word of Portuguese. Enjoys tax breaks. Talks about the Portuguese like they're kind little savages.
Lionel Shriver tells those of us who live here what our country looks like if you leave it + rely on the media ecosystem of the very online right as a proxy for reality
July 24, 2025 at 8:48 AM
This ridiculous woman has migrated to Portugal from the UK because immigration is "wreaking demographic havoc" and "watering down British culture".
A 68-year-old. Plus her family. Doesn't speak a word of Portuguese. Enjoys tax breaks. Talks about the Portuguese like they're kind little savages.
A 68-year-old. Plus her family. Doesn't speak a word of Portuguese. Enjoys tax breaks. Talks about the Portuguese like they're kind little savages.
Reposted by José Pedro Fernandes
T3i
So this evaluation of the 📊 CRIC data showed that eGFRdiff is clinically relevant.
➕ Positive = 👍 CV outcomes
➖ Negative = 🧓 Frailty, 👎CV outcomes, poor functional status
#NephJC
So this evaluation of the 📊 CRIC data showed that eGFRdiff is clinically relevant.
➕ Positive = 👍 CV outcomes
➖ Negative = 🧓 Frailty, 👎CV outcomes, poor functional status
#NephJC
July 23, 2025 at 1:49 AM
T3i
So this evaluation of the 📊 CRIC data showed that eGFRdiff is clinically relevant.
➕ Positive = 👍 CV outcomes
➖ Negative = 🧓 Frailty, 👎CV outcomes, poor functional status
#NephJC
So this evaluation of the 📊 CRIC data showed that eGFRdiff is clinically relevant.
➕ Positive = 👍 CV outcomes
➖ Negative = 🧓 Frailty, 👎CV outcomes, poor functional status
#NephJC
Reposted by José Pedro Fernandes
Estaba pactado, España se lo debía a Portugal por el apagón
June 8, 2025 at 9:45 PM
Estaba pactado, España se lo debía a Portugal por el apagón
Reposted by José Pedro Fernandes
Domperidone, Quetiapine & levomepromazine + rotigotine to control nausea 🤢 & vomiting 🤮 in Parkinson’s
May 30, 2025 at 3:04 PM
Domperidone, Quetiapine & levomepromazine + rotigotine to control nausea 🤢 & vomiting 🤮 in Parkinson’s
Reposted by José Pedro Fernandes
Key #EAPC2025 Learning -role of isopropylic (inhaled, very short acting) & mirtazepine (post synaptic 5HT3 & 5HT4 blockade) for nausea @eapcvzw.bsky.social
a drawing of a unicorn with a rainbow coming out of its mouth .
ALT: a drawing of a unicorn with a rainbow coming out of its mouth .
media.tenor.com
May 30, 2025 at 3:04 PM
Key #EAPC2025 Learning -role of isopropylic (inhaled, very short acting) & mirtazepine (post synaptic 5HT3 & 5HT4 blockade) for nausea @eapcvzw.bsky.social
Reposted by José Pedro Fernandes
UnitedHealth made its own customers “do not resuscitate” status without their consent (or knowledge) in order to increase their profits
May 21, 2025 at 8:22 PM
UnitedHealth made its own customers “do not resuscitate” status without their consent (or knowledge) in order to increase their profits
Reposted by José Pedro Fernandes
Neste dia, 19 de maio, em 1954, Catarina Eufémia foi assassinada.
May 19, 2025 at 12:37 AM
Neste dia, 19 de maio, em 1954, Catarina Eufémia foi assassinada.
Reposted by José Pedro Fernandes
what steroid is the fairest of them all?
for PNA/sepsis, hydrocortisone might be the best (least CNS penetration, so least deleriogenic 🤡)
mineralocorticoid activity may cause fluid retention & hypoK, but it's easy to follow lytes & diurese as needed
discussion: emcrit.org/ibcc/adrenal... #EMIMCC
for PNA/sepsis, hydrocortisone might be the best (least CNS penetration, so least deleriogenic 🤡)
mineralocorticoid activity may cause fluid retention & hypoK, but it's easy to follow lytes & diurese as needed
discussion: emcrit.org/ibcc/adrenal... #EMIMCC
April 30, 2025 at 12:01 PM
what steroid is the fairest of them all?
for PNA/sepsis, hydrocortisone might be the best (least CNS penetration, so least deleriogenic 🤡)
mineralocorticoid activity may cause fluid retention & hypoK, but it's easy to follow lytes & diurese as needed
discussion: emcrit.org/ibcc/adrenal... #EMIMCC
for PNA/sepsis, hydrocortisone might be the best (least CNS penetration, so least deleriogenic 🤡)
mineralocorticoid activity may cause fluid retention & hypoK, but it's easy to follow lytes & diurese as needed
discussion: emcrit.org/ibcc/adrenal... #EMIMCC
Reposted by José Pedro Fernandes
Pembrolizumab-Mediated Complete Remission of a PLA2R-Positive Paraneoplastic Membranous Nephropathy: A Case Report
https://buff.ly/3Qh7uyp
https://buff.ly/3Qh7uyp
February 6, 2025 at 4:47 PM
Pembrolizumab-Mediated Complete Remission of a PLA2R-Positive Paraneoplastic Membranous Nephropathy: A Case Report
https://buff.ly/3Qh7uyp
https://buff.ly/3Qh7uyp
Reposted by José Pedro Fernandes
Our Palliative Care team works alongside and next door to the oncology department, this results in shared patients and best care
PulmCCM woke up and chose violence 😂
The article is, unfortunately, painfully accurate.
Palliative care has been shown to improve & extend life in advanced malignancy, but it’s sorely underutilized.
#EMIMCC
The article is, unfortunately, painfully accurate.
Palliative care has been shown to improve & extend life in advanced malignancy, but it’s sorely underutilized.
#EMIMCC
January 28, 2025 at 9:37 PM
Our Palliative Care team works alongside and next door to the oncology department, this results in shared patients and best care
Anti-XI com menos hemorragias clinicamente significativas em doentes com FA comparando com rivaroxabano
In the AZALEA–TIMI 71 trial, researchers compared the safety of the monoclonal antibody abelacimab with that of the direct oral anticoagulant rivaroxaban in patients with atrial fibrillation. Full trial results and Plain Language Summary: nej.md/3PJcknN
#MedSky #CardioSky
#MedSky #CardioSky
January 28, 2025 at 9:33 PM
Anti-XI com menos hemorragias clinicamente significativas em doentes com FA comparando com rivaroxabano
Reposted by José Pedro Fernandes
The two most reliable ways to do this are:
- urine output
- spot urine sodium measure, taken 2h post-furosemide. You're shooting for effective naturesis, which means a spot urine sodium of at least 60-70
- urine output
- spot urine sodium measure, taken 2h post-furosemide. You're shooting for effective naturesis, which means a spot urine sodium of at least 60-70
January 17, 2025 at 6:19 PM
The two most reliable ways to do this are:
- urine output
- spot urine sodium measure, taken 2h post-furosemide. You're shooting for effective naturesis, which means a spot urine sodium of at least 60-70
- urine output
- spot urine sodium measure, taken 2h post-furosemide. You're shooting for effective naturesis, which means a spot urine sodium of at least 60-70
Reposted by José Pedro Fernandes
Três figuras da canção de Coimbra imortalizadas numa parede da cidade.
António Portugal, Adriano Correia de Oliveira e Rui Pato.
Pintura do projectoruido.pt
António Portugal, Adriano Correia de Oliveira e Rui Pato.
Pintura do projectoruido.pt
December 30, 2024 at 1:42 PM
Três figuras da canção de Coimbra imortalizadas numa parede da cidade.
António Portugal, Adriano Correia de Oliveira e Rui Pato.
Pintura do projectoruido.pt
António Portugal, Adriano Correia de Oliveira e Rui Pato.
Pintura do projectoruido.pt
Reposted by José Pedro Fernandes
The curse of “they are very nice”. What a weird thing to say. Sometimes our own hangups are a barrier to our patients getting the right care. Stop stigmatizing palliative care.
If other medical specialities were stigmatized like palliative care #hapc #palliativecare
December 21, 2024 at 6:10 PM
The curse of “they are very nice”. What a weird thing to say. Sometimes our own hangups are a barrier to our patients getting the right care. Stop stigmatizing palliative care.
Reposted by José Pedro Fernandes
@j-palliativemed.bsky.social Pain and dyspnea were more severe in patients with hyperactive delirium than those without delirium. The presence of hypoactive delirium was not associated with a greater severity of physical symptoms www.liebertpub.com/doi/10.1089/...
December 6, 2024 at 6:44 PM
@j-palliativemed.bsky.social Pain and dyspnea were more severe in patients with hyperactive delirium than those without delirium. The presence of hypoactive delirium was not associated with a greater severity of physical symptoms www.liebertpub.com/doi/10.1089/...
Reposted by José Pedro Fernandes
A two-tiered intervention was implemented, involving training and a new consultation model; this was shown to be feasible and effective in reducing the physical and emotional symptoms of patients with palliative needs managed in primary care. #hapc #hpm buff.ly/4ftkKe9
November 15, 2024 at 10:08 PM
A two-tiered intervention was implemented, involving training and a new consultation model; this was shown to be feasible and effective in reducing the physical and emotional symptoms of patients with palliative needs managed in primary care. #hapc #hpm buff.ly/4ftkKe9
Reposted by José Pedro Fernandes
1/16
🤔Why does carcinoid syndrome affect the right heart valves more often than the left heart valves?
The difference is striking.
Let's have a look.
🤔Why does carcinoid syndrome affect the right heart valves more often than the left heart valves?
The difference is striking.
Let's have a look.
November 16, 2024 at 8:04 PM
1/16
🤔Why does carcinoid syndrome affect the right heart valves more often than the left heart valves?
The difference is striking.
Let's have a look.
🤔Why does carcinoid syndrome affect the right heart valves more often than the left heart valves?
The difference is striking.
Let's have a look.
Mais uma vez… Nefropatia por contraste não existe. Não deixem de fazer exames contrastados por creatinina elevada.
'Conclusion
Based upon the available literature, the use of IV contrast for CT imaging does not appear to be associated with an increased risk of #AKI' acute kidney injury, IV contrast dye for imaging probably dsnt harm kidneys. #angiogram
#emimcc #cardiosky
www.jem-journal.com/article/S073...
Based upon the available literature, the use of IV contrast for CT imaging does not appear to be associated with an increased risk of #AKI' acute kidney injury, IV contrast dye for imaging probably dsnt harm kidneys. #angiogram
#emimcc #cardiosky
www.jem-journal.com/article/S073...
Is Intravenous Contrast Associated with Increased Risk of Acute Kidney Injury?
Computed tomography (CT) is a common imaging modality used in the Emergency Department.
Intravenous (IV) contrast can assist with visualization of pathology, particularly
for inflammatory conditions a...
www.jem-journal.com
December 3, 2024 at 10:23 AM
Mais uma vez… Nefropatia por contraste não existe. Não deixem de fazer exames contrastados por creatinina elevada.
Reposted by José Pedro Fernandes
Reposted by José Pedro Fernandes
This is a ketamine appreciation post
November 15, 2024 at 9:17 PM
This is a ketamine appreciation post
Reposted by José Pedro Fernandes
1/11
🤔Why does chronic hepatitis C infection "require" the intermediary of cirrhosis in order to cause hepatocellular carcinoma (HCC)?
Chronic hepatitis B can "skip" this step, going directly from chronic infection to HCC.
Why the difference?
🤔Why does chronic hepatitis C infection "require" the intermediary of cirrhosis in order to cause hepatocellular carcinoma (HCC)?
Chronic hepatitis B can "skip" this step, going directly from chronic infection to HCC.
Why the difference?
November 11, 2024 at 9:02 PM
1/11
🤔Why does chronic hepatitis C infection "require" the intermediary of cirrhosis in order to cause hepatocellular carcinoma (HCC)?
Chronic hepatitis B can "skip" this step, going directly from chronic infection to HCC.
Why the difference?
🤔Why does chronic hepatitis C infection "require" the intermediary of cirrhosis in order to cause hepatocellular carcinoma (HCC)?
Chronic hepatitis B can "skip" this step, going directly from chronic infection to HCC.
Why the difference?