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The ebook for Approach to Internal Medicine 5e, edited by Hui, Leung, and Ma is out today! Print book to follow. Purchase or access through SpringerLink here: link.springer.com/book/10.1007/9… #internalmedicine

#hpmJC re: #hpm Journal Club surprising is that during washout, there was significant carryover effect not only BiPAP but also HFO arms...

#hpmJC re: #hpm Journal Club maybe because of other mechanisms beyond oxygenation? This was why we changed to parallel design - large carryover effect

#hpmJC re: #hpm Journal Club, high flow, some PEEP, less work of breathing, so resp muscles get to rest? Hypothesis right now. Need to confirm...

#hpmJC re: @tara_esw Dyspnea studies difficult - inpt means very sick, lots of interruptions (e.g. MRI scans), distressed pts.

#hpmJC re: #hpm Journal Club we are conducting one now of HFO on exercise induced dyspnea. Hope to do more as funding comes in!

#hpmJC re: #hpm Journal Club HFO is now mostly used for hosp pts with hypoxemia. Maybe useful for outpts and/or non-hypoxemic? Need more research!

#hpmJC Most hospice in US don't have it. It is in many acute care hospitals. With technology, home version may be coming...

#hpmJC re: Chloe Chin most research in muscular dystrophy pts, and I have not seen deconditioning with NIV. Rather improved survival...

#hpmJC Chi Li great comment. I think if we just focused on HFO it would be much easier... Lots of contraindications with BiPAP

#hpmJC Thanks everyone for joining! Thanks #hpm Journal Club for hosting. Thanks my coauthors esp Eduardo Bruno!

#hpmJC Can also e-mail me ([email protected]) if questions or comments!!! I am still new to tweeter :)

#hpmJC re:annaEbone Both are winners... One pt told me he loved HFO for regular use, and BiPAP for acute episodes. Sums up the two tx!

#hpmJC re:Chi Li Another open label study also showed benefit for BiPAP esp hypercapneic pts. ncbi.nlm.nih.gov/pubmed/23406914. Hard to blind!

#hpmJC have to go! Look forward to future journal clubs.

#hpmJC and thanks to Akhila Reddy M.D. for great support!

#hpmJC yes, more research is needed!!!

4 models of integration of oncology and #palliative care by David Hui & Eduardo Bruno Which one is best? #pallonc #hpm ncbi.nlm.nih.gov/pubmed/26231806

RT Akhila Reddy M.D. Eduardo Bruno Thx Dr. Reddy. We summarized the 4 contemporary integration models: 1.time-based, 2.provider-based/palli-centric,

RT Akhila Reddy M.D. 3.issue-based/onco-centric, and 4.system-based. Dissecting the complex Pt-PC-Onc interface from 4 angles--same conclusions