In the moment of my hooding, I closed my eyes not to shut out the world, but to better feel the weight of responsibility and honor it bestows. Surrounded by those who have nurtured my growth, I step forward ready to heal. #unmcgrad #internalmedicine #firstgen #doctor

Think your blood pressure (BP) is under control?

If it is routinely in the 130-150 range compared to the 110 - 130 range then your risk of:

Major Heart Events ⬆️ 26%
Stroke ⬆️ 33%
Heart Attack ⬆️ 33%
Heart Failure ⬆️ 73%
Heart Death ⬆️ 28%

Still think your BP is under control?

Superb and infuriating piece by UC San Francisco colleague (& great writer) Louise Aronson about how her mom's clear, documented wish to avoid aggressive care at the end of life was ignored by a medical team locked into a we-did-this-so-we-must-do-that spiral. NEJM nejm.org/doi/full/10.10…

Imagine this scene

It's 1980:
🩸variceal bleeds=surgical disease
🚫banding not invented
👶Sclero in its infancy
💉Somatostatin⬇️portal pressure,😢1/2-life
🩸🩸Rebleeding=the norm
⚰️Mortality crazy high

We need a durable way to ⬇️portal pressure!!

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First, why do variceal bleeds happen?

Throwback to this #tweetorial : x.com/ebtapper/statu…

tl;dr

1. #cirrhosis forces blood around the liver
2. Varices are bypass routes
3. Some run in the esophagus/gut
4. They can tear/bleed
5. Tragic

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We absolutely love how awesome our residents are and how they will often have already spun the urine when calling for a consult!!!

Here’s a situation many of us have seen in the ICU or ED: “It looked like there was ST elevation on the monitor but when I took a 12 lead it was gone?!”

A STEMI went MIA? Here’s a #tweetorial all about why ST segments look different on monitors.

#FOAMed #FOAMcc
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My inpatient hypertension management philosophy:

Ask why.
Do less.
Almost never use hydralazine.

Why Preventing Diabetes With Lifestyle Measures

Can Add Over A Decade To Your Life.

📕 Make Sure To Bookmark ✅

🧵👇

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Fantastic presentation by Dr Hilden on why physicians should participate in advocacy ACP Minnesota Acp

About that time for #Match2024 in year 8/8! Unbelievably excited to be applying in #anesthesiology ! Interested in critical care, pediatrics, and of course the mysteries of redox 🧪🧬 Coming with my gold and silver signals to the virtual interview trail near you!!

These drugs are absolutely incredible and are game changes regarding preventative medicine options going forward.

Oral semaglutide at 50 mg once per day led to a meaningful decrease in bodyweight compared with placebo in overweight adults without type 2 diabetes, study finds.
hubs.li/Q020V7DJ0

Just a few more days until we hit the deadline to submit your abstracts!

Some sit down rounds in the Chihuly Garden and Glass with this great IM Green team! UNMC IM Residency #selfiesonservice Jasmine R Marcelin, MD, FACP, FIDSA 🦠

Fantastic audio and review. Worth a listen. podcasts.apple.com/us/podcast/the…

Start thinking now about a case to present at the 2023 NE ACP Abstract Competition! Registration will open July 1, 2023 and close August 27, 2023. Contact [email protected] for more information.

As I wrap up my 5th year of #primarycare practice, I can't help but reflect on the TEN 'sparks' trainees may miss out on during residency that make this work so rewarding.

A 🧵of #gratitude ...

CLOSLER Primary Care Chat @indupartha Adam Cifu Gabe Charbonneau, MD Frank Cacace MD FACP

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