Samir S. Shah
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samirshahmd.bsky.social
Samir S. Shah
@samirshahmd.bsky.social
3.1K followers 1.3K following 420 posts
Editor-in-Chief, @JHospMedicine.bsky.social | Infectious Diseases & Hospital Medicine Physician | Leadership Coach | I write about leadership & mentorship
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samirshahmd.bsky.social
Vancomycin / Nafcillin / Ceftaroline
Andy Reid in a suit, Travis Kelcie in casual dress, Patrick Mahomes in a pink vest and tie.
October 8, 2025 at 1:44 AM
samirshahmd.bsky.social
🌳 How do we as leaders continue to grow? I discuss this question in my latest leadership lesson @jhospmedicine.bsky.social

#Leadership @societyhospmed.bsky.social

shmpublications.onlinelibrary.wiley.com/doi/10.1002/...
September 30, 2025 at 11:12 PM
samirshahmd.bsky.social
If you’ve never seen aspiration on a radiologic study, check out this @jhospmedicine.bsky.social #VisualVignette

🎞️Aspiration pneumonia highlighted on a barium swallow

Video accessible 👉🏽 shmpublications.onlinelibrary.wiley.com/doi/10.1002/...

#HospitalMedicine
Snapshot of a barium swallow study showing aspiration into the airway. The tracheobronchial tree is evident. Video of the visual vignette available @jhospmedicine.bsky.social via link in the message.
September 20, 2025 at 6:40 PM
samirshahmd.bsky.social
👶🏽🩺 #SanfordGuidePediatric update

➕ New topic added: Cyclic Vomiting Syndrome

✅ Got to cite the work of 💫colleagues💫@cincyresearch.bsky.social on an auricular percutaneous nerve stimulation as a potential therapy that was published earlier this month
@sanfordguide.bsky.social
Screenshot showing a portion of the cyclic vomiting syndrome topic in the Sanford Guide to pediatric acute care app that addresses is diagnostics. Screenshot showing the portion of the management section of cyclic vomiting syndrome in the Sanford Guide to pediatric acute care app that addresses, percutaneous electric nerve stimulation as a potential therapy.
August 17, 2025 at 12:05 AM
samirshahmd.bsky.social
👶🩺 #SanfordGuidePediatric Update

🆕 in @jama.com July 30, 2025 pubmed.ncbi.nlm.nih.gov/40736730/

➕ New topic: 🦠Influenza with guidance on identifying influenza-associated complications, including the recently reported series of pediatric acute necrotizing encephalopathy

@sanfordguide.bsky.social
Screenshot of the first screen of the newly added Influenza topic in the Sanford Guide to Pediatric Acute Care app. This screenshot shows the epidemiology and etiology of influenza, including specific information on associated infections, hospitalizations, and deaths each year. This image is a screenshot of the complications section of the influenza topic in the Sanford Guide to Pediatric Acute Care app. There is specific mention of acute necrotizing encephalopathy as noted in the JAMA paper published July 30, 2025, with the link in the post.
August 3, 2025 at 7:59 PM
samirshahmd.bsky.social
👶🩺 #SanfordGuidePediatric Update

🆕 July 2, 2025, Phase 2 RCT @jamanetworkopen.com examining 💊vancomycin secondary prophylaxis in adults receiving ongoing systemic antibiotics

➕ We highlight absence of pediatric data & share adult studies

jamanetwork.com/journals/jam... @sanfordguide.bsky.social
August 3, 2025 at 2:11 PM
samirshahmd.bsky.social
Great science 🧪 & great colleagues at #PHM25. My visit was too short. Lookin forward to next year @societyhospmed.bsky.social @ameracadpeds.bsky.social #SanfordGuidePediatric #AcademicPediatricAssociation #hospitalmedicine
#PHM2025
Photo of a navy blue Mac laptop with 2 stickers slightly above and lateral to the Apple logo. On the left is a circular Journal of Hospital Medicine-branded sticker. The top half of the circle is a light blue, the bottom half is dark blue and a thin yellow line bisects the two halves. The top half has the Journal of Hospital Medicine logo in white and the bottom half has, also in white, #HowWeHospitalist and the society of hospital medicine logo. The image on the right is a white square with rounded edges. It resembles how app me appear on phones and tablets. In black lettering are the words “Sanford Guide” at the top and “Pediatric Acute Care” at the bottom. Centered in between are two smaller squares in purple with images in white. The left has a stick figure baby head and the right is a stethoscope; these represent the Sanford Guide to Pediatric Acute Care logo.
July 26, 2025 at 7:56 PM
samirshahmd.bsky.social
👶🏽🩺 #SanfordGuidePediatric

🆕 We’ve added Developmental & Behavioral Medicine content

😴 #Autism what I love about this is the very practical guidance for both the inpatient and outpatient setting. A few snippets from the app
@sanfordguide.bsky.social #MedSky #PedSky
Screenshot from the Sanford Guide to pediatric acute care showing the autism, overview topic. This particular screenshot shows a portion of the DSM-5 definition. Screenshot from the Sanford Guide to pediatric acute care showing the autism, overview topic. This particular screenshot shows a portion of management guidance for the outpatient setting. Screenshot from the Sanford Guide to pediatric acute care showing the autism, overview topic. This particular screenshot shows a portion of the management section for the inpatient setting.
July 22, 2025 at 12:00 AM
samirshahmd.bsky.social
👶🏽🩺 #SanfordGuidePediatric

🆕 We’ve added Developmental & Behavioral Medicine content

😴 #Sleep disorders
Screenshot showing contact from the Sanford Guide to Pediatric Acute Care app on the topic of pediatric sleep disorders. This screenshot shows normal sleep parameters and children. Screenshot showing contact from the Sanford Guide to Pediatric Acute Care app on the topic of pediatric sleep disorders. This screenshot shows daytime behavior modifications. Screenshot showing contact from the Sanford Guide to Pediatric Acute Care app on the topic of pediatric sleep disorders. This screenshot shows nighttime environmental adjustments. Screenshot showing contact from the Sanford Guide to Pediatric Acute Care app on the topic of pediatric sleep disorders. This screenshot highlights pharmacological interventions and indications acknowledging that the medications are not FDA approved.
July 20, 2025 at 4:31 PM
samirshahmd.bsky.social
👶🩺 #SanfordGuidePediatric Update

➕ @nejm.org placebo-controlled RCT (July 16, 2025)

💊 Providing 6-doses ondansetron after ED visit w/ #gastroenteritis led to lower risk of moderate-to-severe gastroenteritis during next 7 days

pubmed.ncbi.nlm.nih.gov/40673584/
#MedSky @sanfordguide.bsky.social
July 19, 2025 at 3:05 PM
samirshahmd.bsky.social
Also, as others have noted, cat bites are high-risk for infection.
Screenshot of the epidemiology and etiology section of the Bite Wound Infections topic from the Sanford Guide to Pediatric Acute Care. Of particular relevance to this post is that approximately 50% of cat bites end up infected and Pasteurella species bacteria from the cat’s mouth commonly cause the infection.
July 13, 2025 at 6:48 PM
samirshahmd.bsky.social
👶🏽🩺 We’ve added the Pediatric Ulcerative Colitis Activity Index #PUCAI calculator to #SanfordGuidePediatric
Pediatric ulcerative colitis activity index calculator screenshot from the Sanford Guide to pediatric acute care Pediatric ulcerative colitis activity index calculator screenshot from the Sanford Guide to pediatric acute care. This image shows the last few variables as well as the button to calculate the index Pediatric ulcerative colitis activity index calculator screenshot from the Sanford Guide to pediatric acute care. This particular image shows how one interprets the score with remission being a score of less than 10, mild being a score of 10 to 34, moderate being a score of 35 to 64, and severe being a score of 65 or greater
July 9, 2025 at 4:55 PM
samirshahmd.bsky.social
💡 @jhospmedicine.bsky.social - where innovation meets implementation.

shmpublications.onlinelibrary.wiley.com/index/155356...
A graphic consistent with Journal of Hospital Medicine branding promotes innovations corner, which is an article type used to showcase innovative care, delivery models that have been scaled or have high potential to scale. The graphic also includes information on how to accelerate change via this article type.
July 6, 2025 at 4:09 PM
samirshahmd.bsky.social
🖼️ New picture for the office wall

#SanfordGuidePediatric

@sanfordguide.bsky.social
Logo of the Sanford Guide to Pediatric Acute Care app appearing in 3 rows of 3 logos. The surrounding frame is a 1/2 inch thick and made of brushed silver. The picture is double matted with a purple mat as the top layer with an ~1/4 inch border inner white mat with a deep purple core.
June 29, 2025 at 3:20 AM
samirshahmd.bsky.social
👶🏽🩺Though most people use the search function to identify relevant content in #SanfordGuidePediatric we added a Table of Content to orient users.

Many thanks to those users who provided the input prompting this addition.

@sanfordguide.bsky.social
Screenshot of the home page of the Sanford Guide to Pediatric Acute Care with a circle in purple “marker “ highlighting the quick link to the table of contents. Screenshot of the first few topics in the Sanford Guide to Pediatric Acute Care, including adolescent medicine and asthma allergy and the relevant topics within those content areas. Screenshot of the first portion of the infectious diseases content area in the Sanford Guide to Pediatric Acute Care, which is arranged alphabetically. Screenshot of a second portion of the infectious diseases content area in the Sanford Guide to Pediatric Acute Care, which is arranged alphabetically. This screenshot shows topics through fever of unknown origin.
May 31, 2025 at 12:21 PM
samirshahmd.bsky.social
Rooting around in my office for a snack and came across these #JHM&Ms from 2022.

Safe to eat? Too late. Don’t answer that question. At this point, I’m better off not knowing, or rather the answer will be apparent in the next 3-24 hours. @jhospmedicine.bsky.social
A mug filled with custom yellow, darker blue and lighter blue M&Ms each emblazoned with one of the following: the Journal of hospital medicine social media handle (@JHospMedicine), #LeadingByExample, mug icon, the latter in reference to the logo mugs previously given away by the journal. The mug sits on a coaster with the Journal hospital medicine logo. Just a small portion of the logo is visible.
May 22, 2025 at 8:11 PM
samirshahmd.bsky.social
What does “ #Measles was declared eliminated from 🇺🇸 in 2000” actually mean?

🚫 No locally transmitted infections for 12 consecutive months, i.e., no natural spread

🕵️ High quality surveillance system in place, i.e., you have a good way to detect new cases

Graph shows US measles cases over time.
Graph from the Centers for Disease Control and Prevention showing measles cases in the US over time from the year 2000 to May 15, 2025. Notably, there are more cases from January 1-May 2025 than the number of cases in 2020-2024 combined. Notably, there were >1200 measles cases in 2019. It is possible that we will exceed that number by end of June 2025.
May 22, 2025 at 3:55 AM
samirshahmd.bsky.social
The lighting is good today, my friends.
Screenshot of Samir S. Shah, a gracefully aging pediatrician who practices both hospital medicine and infectious diseases, from a virtual meeting this morning.
May 21, 2025 at 2:22 PM
samirshahmd.bsky.social
Acute? Absolutely. Cute? Well, I’ll let our logo answer that question… 👶🏽🩺
Picture of the Sanford Guide to pediatric acute care logo. There is a white box with rounded corners. In black lettering at the top of the box it says Sanford Guide. At the bottom of the box, it says pediatric acute care. In between those two sets of words there are two purple boxes with rounded edges next to one another. In the left box, there is a “Stick Figure baby head” drawn in white and in the right box there is a stethoscope drawn in white.
May 20, 2025 at 1:03 AM
samirshahmd.bsky.social
Cover letters for your research manuscript submission?✳️

There is a simple, highly effective structure: 1-2 sentences per section.

✔️ Context
✔️ What we did
✔️ What we found
✔️ Why it's important

@jhospmedicine.bsky.social

🆓 at shmpublications.onlinelibrary.wiley.com/doi/10.1002/...

✳️Yes
Sample cover letter: Box 1.. Sample cover letter using an article by Burden et al.1 as the reference point. Dear Editors: [Introduction] We are pleased to submit our manuscript “Discharge in the AM: A Randomized Controlled Trial of Physician Rounding Styles to Improve Hospital Throughput and Length of Stay”. [Context] Medical centers across the U.S. face capacity strain, characterized by an excess demand for hospital beds relative to available supply and staffing. To alleviate this strain, hospitals often encourage clinicians to prioritize early morning discharges. However, observational studies on the effectiveness of this practice have yielded mixed results, and the potential unintended consequences remain unexplored. [What we did] Over ~6 months, hospital medicine physicians were randomized to prioritize discharging patients first or round per usual practice. [What we found] We found that prioritizing discharging patients first 1) did not result in earlier discharges or significantly reduced length of stay, 2) did not cause delays in placing other patient care orders, suggesting that physicians adapted their workflow to address patient needs, and 3) led to perceptions of inefficiency. [Why it's important] Hospitals may not need to emphasize or incentivize prioritizing patient discharges over usual patient rounds. Such initiatives may actually be counterproductive by causing inefficiencies such as repeating work and requiring additional travel time to units across the hospital. [Highlights elements required for publication] This study was approved by the Colorado Multiple Institution Review Board, registered through clinicaltrials.gov (NCT05370638), and funded by the Agency for Healthcare Research and Quality (1R03HS027231-01A1).
May 19, 2025 at 11:27 PM
samirshahmd.bsky.social
Wonderful essay. If you’re not in medicine (or if you live outside the US), you may want to sit down before reading this explainer on reimbursement for care provided by #InfectiousDiseases physicians
Screenshot of a quote from the essay which quotes an Atul Gwande Nee Yorker essay on reimbursement for infectious diseases, physicians. An ID physician spending an hour making complex life-saving diagnosis would be paid $40. In contrast for someone spending an hour doing a colonoscopy and exercising a polyp they receive more than $600. These data, of course are from a number of years ago.
May 18, 2025 at 12:36 PM
samirshahmd.bsky.social
👶🩺 Sanford Guide to Pediatric Acute Care app UPDATE❗

Content area: #Nephrology

🟣 Added info from RCT in @jama.com #pediatrics (May 12, 2025) comparing tacrolimus & MMF in frequently relapsing or steroid-dependent #NephroticSyndrome

📘 jamanetwork.com/journals/jam... @sanfordguide.bsky.social
Screenshot of the Sanford Guide to Pediatric Acute Care app showing newly added text that incorporates treatment information on Relapsing or Steroid-dependent nephrotic syndrome based on the clinical trial published in JAMA Pediatrics on May 12th. PMID: 40354041 showing that tacroliums leads to a longer time to first relapse, fewer replases within the first year of life, and lower cumulative steroids dose at one-year compared with mycophenolate mofetil. The new text also states that because long-term tacrolimus use is associated with nephrotoxicity and chronic kidney disease, some centers prefer MMF or rituximab before tacrolimus.
May 17, 2025 at 1:15 PM
samirshahmd.bsky.social
Your intermittent dose of #Rocket & #Benny
A “Red Tri” Australian Shepherd A Red Merle Australian Shepherd dog smiling and looking very cute after his haircut.
May 17, 2025 at 1:20 AM
samirshahmd.bsky.social
💉Virtually no physician or nurse completing training in past quarter century has seen Haemophilus Influenzae type b #Hib. I hope we don’t see a resurgence of this vaccine-preventable infection. Added it to the Sanford Guide to Pediatric Acute Care, just in case.
@sanfordguide.bsky.social
Screenshot of the first section (epidemiology) of the topic Haemophilus influenzae type b infections from the Sanford Guide to pediatric acute care app. Screenshot from the Sanford Guide to pediatric acute care app. The image shows a portion of the management section. Among the key points are plasma mediated resistance, which makes ceftriaxone rather than amoxicillin the first line antibiotic. Dexamethasone has been shown when administered before or at the same time as the first dose of antibiotics to reduce the frequency of hearing loss in Hib meningitis.
May 1, 2025 at 5:52 PM
samirshahmd.bsky.social
Best advice you’ve ever received? Loved the comment from one of the children in attendance: “Be nice to yourself!”

#PAS2025 @cincyresearch.bsky.social @cincychildrens.bsky.social
Message board from the Cincinnati Children’s Hospital booth that asks “What’s the best advice you’ve ever received?” Posted in speech bubbles are the written comments from those who stopped by the booth. Message board from the Cincinnati Children’s Hospital booth that asks “What’s the best advice you’ve ever received?” Posted in speech bubbles are the written comments from those who stopped by the booth. These are additional comments as they did not all fit in a single photograph.
April 27, 2025 at 9:49 PM