Why is your pt's ALT (or AST) >1000? A #livertwitter #tweetorial Take-homes: 1. Top 3 causes of acute liver injury 2. I always say it's ischemic hepatitis; 50% of the time, I'm right every time Brought to u by: Tony Goncalves et al. What causes severe ALI? cghjournal.org/article/S1542-…

Crowdsourcing this ECG that a colleague sent me. I don't know much history other than there has been no heart surgery and no dig use RR intervals are stable (I have never seen such a thing.)

Key point from my invasive CO talk the other day #CHEST2025

Do not wait for Central line insertion to initiate Noradrenaline infusion in case of shock. Peripheral IV access is safe to start Noradrenaline. Much needed myth busters by Bharat Jagiasi sir and team. Also attached are recommendations from recent safe vascular access guidelines

Enteral ventilation (delivering oxygen through the rectum, aka "butt breathing") sounds wild, but the method was just shown to be safe in its first human trial. This has the potential to save numerous lives by delivering oxygen through the rectum to bypass damaged lungs.

🚨 New ESICM Guidelines Released! The 2025 ESICM Guidance on Circulatory Shock & Hemodynamic Monitoring provides 50 expert statements defining what to assess, when to intervene, and how to monitor in adult ICU patients. Delighted to see IFA Executive Board Members Prof.

New episode out today wrapping up our asthma guidelines series! pulmpeeps.com/2025/10/28/109… Infographics below 👇 Stay tuned for our next guidelines series about Pulmonary Hypertension! American Thoracic Society (ATS) CHEST Global Initiative for Asthma (GINA) CORE IM The Curbsiders PulmCCM Nick Mark MD

Clinicians can enhance patient understanding by using numerical data instead of verbal probabilities, consistent denominators, absolute risk comparisons, and clear context for unfamiliar data types. ja.ma/4od48LR

💬 Editorial: The BICARICU-2 trial finds IV sodium bicarbonate may delay or reduce kidney replacement therapy in #criticallyill patients with severe #acidemia and #AKI, but its effect on mortality remains uncertain. #LIVES2025 ESICM ja.ma/3Lf2b32

Presented at #LIVES2025: In the EVERDAC trial involving patients with shock, results for death at day 28 indicated that management without early arterial catheter insertion was noninferior to early catheter insertion. Full trial results: nej.md/3LmOO0D Editorial: A

The ANDROMEDA-SHOCK-2 is finally released!! We found that a personalized resuscitation targeting capillary refill time through simple bedside hemodynamic tools was superior to usual care for the composite of mortality/vital support/hospital stay and for faster decrease in SOFA.

📊 Research Summary: Personalized resuscitation targeting capillary refill time modestly improved organ support–free days and composite outcomes in early septic shock, but showed no difference in mortality vs usual care. #LIVES2025 ESICM ja.ma/47de6XI

Presented at #LIVES2025: In a pragmatic trial conducted in general medical wards with limited diagnostic and therapeutic resources in Kenya, glucocorticoids reduced mortality in patients with community-acquired pneumonia. Full trial results: nej.md/47glh02 Editorial:

I’ve been waiting for someone to do this study for years! 🎉 Thanks 👏, Muller & team, for this incredibly important and, I truly believe, practice-changing work. ✔️ out my editorial which, I hope, highlights the importance of the study’s findings: nejm.org/doi/full/10.10…

The prognosis of liver disease depends on the extent of fibrosis, which is usually staged with the use of liver biopsy. The limitations of biopsy have led to the development of noninvasive tests, which Drs. Laurent Castera, Mary E. Rinella, and Emmanuel A. Tsochatzis review.

Physicians are some of the highest earners in the country. And some of the biggest over-payers in taxes. Here are 18 of the most common tax mistakes I see physicians make every year (and how to avoid them):

Seven years after we introduced OMI, the flagship Journal of the European Society of of Cardiology finally seems to be recognizing OMI. Although the ECG patterns that they mention are not at all the most important. HyperAcute T waves, and ST depression in V1-4 are among the

The hyperacute T wave (HATW) score is the first objective definition of HATW showing significant clinical utility as an #ECG finding of acute coronary occlusion in potential acute coronary syndrome patients. jacc.org/doi/10.1016/j.… #JACCAdvances #cvACS #STEMI Pendell Meyers

There are really just two things to evaluate when interviewing with residency programs: 1) quality of training 2) quality of life while in training it’s easy to lose the forest in the trees.

A new review summarizes the genetics, diagnosis, and treatment of long QT syndrome, a major cause of sudden death in young people. Risk stratification and genotype-guided therapy are essential. Learn more in the Review Article “Long QT Syndrome” by Peter J. Schwartz, MD, and