@doctorvec

Community Based Internal Medicine Program Director. Father. Horrible golfer. Tweets are not medical advice.

 Myrtle Beach, SC
Joined February 2016
  • Tweets1.6K
  • Following275
  • Followers219
158Media
I think we have answered this question. But just in case its needed. jamanetwork.com/journals/jam…

One-Time and As-Needed Blood Pressure Medication and Adverse Outcomes in VA Hospitals

This cohort study evaluates the risk for acute kidney injury and other adverse effects from as-needed and 1-time blood pressure medications in hospitalized veterans.

jamanetwork.com
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Great review article on DKA and EDKA (SGLT-2) ccjm.org/content/92/1/33
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Welcome the GSMC IM Class of 2023. Looking forward to working with all of you.
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74 year old admitted with pneumonia. Nurse calls you at 2 am for BP of 210/104. She has no symptoms. Renal function that am was normal. EKG is normal. Vitals otherwise normal. She took her AM anti-HTN medications. What is you current practice?
50%Repeat in 3 hours
17%IV anti-HTN
33%Oral anti-HTN
12 votes • Final results
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More evidence we are harming and certainly not helping patients with asymptomatic severe HTN by treating with IV anti-HTN. When will it stop!!!! journals.lww.com/jhypertensi…

Effect of intravenous antihypertensives on... : Journal of Hypertension

Background:Treatment of severe inpatient hypertension (HTN) that develops during hospitalization is not informed by guidelines. Intravenous (i.v.)...

ovid.com
65
It is my experience we (me included) often under-dose diuretics and do not follow up to assess response. Below is a great table on how to approach initial dose. I also am attaching a link to the article in CCJM. ccjm.org/content/89/10/561
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Am I the only one who thinks Pure Wick catheters were invented to immobilize patients and increase admissions to rehab facilities
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I have failed as a medical educator.
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Not a perfect trial but not the result I expected. jamanetwork.com/journals/jam…

Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Heart Failure

This clinical trial compares the efficacy of torsemide vs furosemide in decreasing the risk of death from any cause among patients hospitalized for heart failure (regardless of ejection fraction).

jamanetwork.com
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Today is my 50th bday. My residents all dressed in black to signify the death of my youth.
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As a primary care physician or hospitalist how do you approach patient the HFrEF not on GDMT who follow long-term with Cardiologists. #medtwitter #cardiotwitter
25%Adjust/Add Meds
75%Contact Cards
0%Patient contact cards
0%Bury head in sand
4 votes • Final results
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So I decide not to change back into formal clothes after taking an afternoon walk prior to a late meeting. Great timing for presenting me with a plaque recognizing my commitment to GME at our institution. I need a retake!!
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I am hoping this is a sign that my faculty are out doing bedside rounds.
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I need an APD and a inpatient core faculty if anybody wants to move to Myrtle Beach
Most often, people are doing the best they can.
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Did my annual don’t aggressively treat asymptomatic inpatient HTN talk to the new interns. Hoping this will be the class to stamp out the hydralazine epidemic.
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Small study. But compelling for early use of SGLT-2 inhibitors in acute heart failure. ahajournals.org/doi/10.1161/…

Effects of Early Empagliflozin Initiation on Diuresis and Kidney Function in Patients With Acute...

Background: Effective diuretic regimens using loop diuretics in patients with acute decompensated heart failure are often limited by the development of worsening kidney function. Sodium-glucose...

ahajournals.org
I like this!!
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“Responsibility is not doing what your are told, that is obedience. Responsibility is doing what is right’” Simon Sinek
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