Medicine focuses a lot on the question “will this help my patient” but not on the question “when will it help my patient.” The latter becomes important as we age. We’ve developed a “time-to-benefit” tool on to help answer this question. #FOAMed# #meded#

36% reduction in urine cultures (although trending down before intervention) and 36% reduction in antibiotic use with no change in LOS, transfer to higher level of care, or mortality using BLADDER score in work-up of potential UTI.

Clinical reasoning just got a revamp! Honored & thrilled to introduce the new direction for the @JournalGIM Exercises in Clinical Reasoning. Exciting times ahead with my fantastic co-editors @Sharminzi @AnandJag1 Check it out & send us your submissions! 🔗

#TipsForNewDocs# Ask the right questions: “Do you get short of breath lying flat? Do you prop yourself up on pillows to breathe?” Not “How many pillows do you sleep on?” Just because a patient sleeps on 2 pillows doesn’t mean they have orthopnea. #kittlesonrules#

🌟 SYNCOPE - Types 🔸️Neutrally mediated syncope 🔸️Orthostatic hypotension 🔸️Cardiac syncope From : 2018 ESC Guidelines for the diagnosis and management of syncope

American Heart Association proposes to omit the following terminologies in it's latest scientific statement (May 2014) ❌️ 𝙃𝙮𝙥𝙚𝙧𝙩𝙚𝙣𝙨𝙞𝙫𝙚 𝙪𝙧𝙜𝙚𝙣𝙘𝙮 ❌️ 𝙃𝙮𝙥𝙚𝙧𝙩𝙚𝙣𝙨𝙞𝙫𝙚 𝙘𝙧𝙞𝙨𝙞𝙨 Use of subjective emotive language such as 𝙘𝙧𝙞𝙨𝙞𝙨 and 𝙪𝙧𝙜𝙚𝙣𝙘𝙮 fail to acknowledge the nuances of treatment decisions and may encourage unnecessary antihypertensive treatment. Therefore in a statement paper from AHA in May 2024, it is proposed the following objective terminology: ✅️ 𝙃𝙮𝙥𝙚𝙧𝙩𝙚𝙣𝙨𝙞𝙫𝙚 𝙚𝙢𝙚𝙧𝙜𝙚𝙣𝙘𝙮 🔸️SBP/DBP >180/110–120 mm Hg with evidence of new or worsening target-organ damage ✅️ 𝘼𝙨𝙮𝙢𝙥𝙩𝙤𝙢𝙖𝙩𝙞𝙘 𝙢𝙖𝙧𝙠𝙚𝙙𝙡𝙮 𝙚𝙡𝙚𝙫𝙖𝙩𝙚𝙙 𝙞𝙣𝙥𝙖𝙩𝙞𝙚𝙣𝙩 𝘽𝙋 🔸️SBP/ DBP >180/110–120 mm Hg without evidence of new or worsening target-organ damage ✅️ 𝘼𝙨𝙮𝙢𝙥𝙩𝙤𝙢𝙖𝙩𝙞𝙘 𝙚𝙡𝙚𝙫𝙖𝙩𝙚𝙙 𝙞𝙣𝙥𝙖𝙩𝙞𝙚𝙣𝙩 𝘽𝙋 🔸️SBP/DBP ≥130/80 mm Hg without evidence of new or worsening target-organ damage. Source : The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart Association

Good Morning from #SGIM2024# #Medtwitter# ! Get those shoulders, knees and toes loosened for the Joint pain thought train 💪🚂. As always, feedback is much appreciated. (thinking about doing a rheum series! :D) Much thanks to @SarahGoglinMD @CPSolvers

Rising #MedTwitter# #MedX# interns, here are my favorite approaches for acute inpatient medicine issues! 🚨 1) Hypoxemia, by @ClementLeeMD 🫁 Ditch the alveolar gas equation (sorry @PulmPEEPs) & use this practical approach.

Should we start statins for primary prevention in older adults? 2x RCTs are ongoing. In the interim, this propensity score matched analysis found that statins users had lower mortality and MACE independent of frailty status. #MedTwitter# @AGSJournal

Hey #MedTwitter# #hospitalmedicine# look at this amazing diagram from @jacionline showing a timeline of typical onset of various drug hypersensitivity syndromes. Thanks @KimberlyBlumen1 and team!

Well , non Infectious But.... very common! Today,my patient with K= 5.8 Internal Medicine team recommended ECG Things We Do for No Reason: Obtaining an electrocardiogram for managing mild hyperkalemia in hospitalized adults #MEded# @medrants @BradSpellberg

Interesting view on Advance Care Planning: Limited value in stating preferences for future hypothetical scenarios More useful for (1) illness education (2) eliciting values/goals to guide current decisions (3) Preparation for future end of life decisions

The medical education community on X is unparalleled. Here are some of my favorite posts and threads related to #meded# from 2023! Each and every one of these exceptional educators deserves a follow! What posts/threads would you add? 1/27