Discover and read the best of Twitter Threads about #GrandRounds
Most recents (20)
Just listened to @BedsideRounds episode #72 entitled “Problems” with Dr. Adam Rodman. Why do we spend so much time on documentation and why does it matter? @Gurpreet2015 @AdamRodmanMD podcasts.apple.com/us/podcast/bed…
1. How we document is how we think: as early as the 18th century, notes started off with communicative and didactic purpose
-19th into 20th century notes: closer to the modern H&P.
-19th into 20th century notes: closer to the modern H&P.
2. A lot of things that exists that we do don’t exist for a rationalist reason, but rather for historical contingency. It happens in medicine all the time!
3. The way that we document today was born out of two parallel movements.
3. The way that we document today was born out of two parallel movements.
. @rbganatra and I had pleasure of presenting talk on 2021’s most important papers in #HospitalMedicine @BIDMC_medicine #GenMed #GrandRounds. Here are our (abbreviated) 🔑points.
Anyone wanting to watch the video (with nerdy jokes) can click here:
vimeo.com/699850485
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Anyone wanting to watch the video (with nerdy jokes) can click here:
vimeo.com/699850485
🧵
1/
Article selection: reviewed the major med journals ➕ JWatch Hospital Medicine for articles that were practice-changing or practice-confirming in setting of sparse data.
Covered the following 8 questions:
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Covered the following 8 questions:
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First, does contrast->CKD/AKI❓ Retrospective cohort w/ regression discontinuity design in all EDs in Alberta 🍁 2013-2018. >150k w/ D-dimer during ED visit (no RRT in prior 6 mos).
1o outcome: long-term renal f’n (eGFR up to 6 mos post index visit).
jamanetwork.com/journals/jamai…
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1o outcome: long-term renal f’n (eGFR up to 6 mos post index visit).
jamanetwork.com/journals/jamai…
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1/3
Fantastic #grandrounds by @lmraomd @UCLAMCH
Neuro complications of #Covid in children
🧠Loss of smell (anosmia) and taste (ageusia) >80%
🧠Headaches typically don't respond to analgesics.
🧠Dizziness can also be seen
#pedsICU #pedsneuro @uclachildneuro @timbooth75
Fantastic #grandrounds by @lmraomd @UCLAMCH
Neuro complications of #Covid in children
🧠Loss of smell (anosmia) and taste (ageusia) >80%
🧠Headaches typically don't respond to analgesics.
🧠Dizziness can also be seen
#pedsICU #pedsneuro @uclachildneuro @timbooth75
We are eager to learn from this #GrandRounds by @OHSU_ID faculty @lstrnad5 and @SikkaMon regarding the overlap between complex bacterial infections and SDOH
Looking at rates of IUD-associated bacterial infection versus other Oregon demographics.
These infections are more common in poorer and more rural areas
These infections are more common in poorer and more rural areas
Racial disparities also exist in Oregon. Black individuals accord for a disproportionate % of IUD infection related admissions versus the 2% of general population
#GrandRounds today by @vaportland faculty Dr. Kate Mackey (and alumna/former chief resident) about evidence synthesis in the era of covid19 including overview of the VA Evidence Synthesis Program (ESP). Many thanks also for the mentorship of TEN residents working with the project
One of the research/writing teams including resident @DrLiederbauer and recent grad (& incoming faculty) @kieferm2 leading to this publication in @AnnalsofIM !
acpjournals.org/doi/10.7326/M2…
acpjournals.org/doi/10.7326/M2…
#OHSUscholarship #GrandRounds—if it’s been happening for over 5 years, we can call it a long standing tradition!
Celebrating the scholarly work of our residents today ~ through knowledge and curiosity, may we work to help our communities, patients, and profession!
Celebrating the scholarly work of our residents today ~ through knowledge and curiosity, may we work to help our communities, patients, and profession!
Dr. Jenna Anderson shared her multidisciplinary work on developing an acute pancreatitis care guideline across the OHSU enterprise and partner hospitals #OHSUscholarship @OHSUsurgery @OHSU_DHM
Dr. @DrSimoneDekker sharing her research critical illness, traumatic injury, and gene expression
Dr. Mukerji kicking off @MGHNeurology #grandrounds on #COVID19 and neurology by reviewing @JAMA_current series- neurological complications started early in course of disease, most common: dizziness, headaches, impaired consciousness, stroke, then neuromuscular.
Neuro symptoms in 45.5% in severe #COVID19, 30.2% in mild COVID. But newer studies suggest this is an underestimate.
1). “Freedom is a road seldom traveled by the multitude”— Renaldo Williams started his #chieftalk this morning @VUMCSurgRes with this Frederick Douglass quote— and took us down several personal roads in an incredibly thoughtful and moving #grandrounds. Thread follows....
2). It was about roads— the many different types of roads that get us from one place to another— some unmarked, some treacherous, some worn, some patched. And he reflected on his road— from Holmes County #Mississippi where 45% live in poverty.
3). To successfully navigate any road, you need a map and a compass (value systems), rest stops (opportunities that open doors), and guides (mentors).
Fascinating #grandrounds on “Preventative Cardiology: the birth of a subspecialty” by Dr. Sergio Fabio @OHSUCardio—combining forces of cardiology and endocrinology to move the focus of care much more upstream
Cardiac rehab is underutilized, and underutilized in preventative cardiology!
“Can you prescribe kale?”
Preventative cardiology is multidisciplinary including pharmacist and dietician—but beyond “eat this/don’t eat this”—getting produce directly to patients with home delivery!
Preventative cardiology is multidisciplinary including pharmacist and dietician—but beyond “eat this/don’t eat this”—getting produce directly to patients with home delivery!
2nd case presented at Grand Rounds today. The clues to the diagnosis are all in this famous Rembrandt painting. What’s your diagnosis? #IDMeded #IDgrandrounds #grandrounds @WashUID
Correct! This is the portrait of Gerard de Lairesse, displayed at the Metrop Museum of Art. Frontal bossing of Parrot, saddle nose, rhagades are just some of the many features of congenital syphilis depicted by Rembrandt. ncbi.nlm.nih.gov/pmc/articles/P…
The case presented today was a neonate who presented with fever, URI, and a diffuse discoid rash thought to be from neonatal lupus. RPR/TPA + so as mom’s. Cord blood negative (5% false negative RPR because of the Wharton Jelly within the umbilical cord).
Wonderful to have @LisaB_MD from @GistHealthcare giving the Paul Mason Lectureship for #IMED #GrandRounds today: The Future of #Healthcare
Always so insightful!
Follow thread...
Always so insightful!
Follow thread...
“Our #USEconomy in a nutshell? We are a huge insurance company w a bunch of tanks and planes!”- @LisaB_MD
Fascinating #GrandRounds @renalpolitics @OHSUNephrology on dialysis for undocumented patients and emergency only dialysis v what states have some Medicaid coverage for this patient population
Emergency only dialysis v scheduled? Almost four times the cost for 2/3rd number of sessions.
There is also data that emergency only dialysis is a driver of burnout for those who end up providing it and caring for patients who depend on it
It’s one of our favorite #GrandRounds of the year! SIXTH annual “celebrating achievements in resident scholarship”!! @OHSUSOM @OHSUNews
Dr. Hunter Spencer presenting his fascinating case of bile cast nephropathy, which has been an invited oral talk at #SGIMNW18 #OHSUscholarship
Packed house for @OHSUSOM dept med #GrandRounds w @svenjammin & @Clotmaster @OHSUKnight: “Delivering on the promise of anticoagulation without bleeding via contact pathway inhibition: There will (not) be blood”
Super neat discussion on evolutionary pathways w acquisition of clotting factors. Yes, if you zoom in, the graphic says “did anything happen here?” Between hagfish and lamprey #GrandRounds
Also neat historical history w Factor XII and John Hageman, found to have prolonged clotting time but no bleeding predilection, and died of pulmonary embolism! #GrandRounds #historyofmedicine
en.m.wikipedia.org/wiki/Factor_XII
en.m.wikipedia.org/wiki/Factor_XII
#ChiefResident blog #WINOFTHEWEEK: shoutouts to APD Drs. @katieiossi and Assistant PD @aoglasser who both made a splash this week online! imrespdx.com/imrespdx-blog/…
Dr. O'Glasser gave @OHSUSOM Dept of Medicine #GrandRounds on #medtwitter with a #tweetorial posted afterwards. it quickly went viral, gaining tremendous feedback as the "gold standard" for discussions about academic use of social media.
#GrandRounds @Bloodman proximal DVT treatment? 3 months. Also get ultrasound at end of treatment to establish post tx “baseline”—evidence of scar tissue can prevent dx of “recurrent” or “chronic” DVT
3 month applies if provoked! If truly idiopathic, still need better prediction rules for who will have another VTE. Newer anticoagulants shifting risk/benefit of long term therapy
Long term options with DOACs. Don’t forget the larger loading dose, consider low dose for long term therapy after treat with usual dose
#GrandRounds Noble Wiley @jpkassirer did you know he introduced the clinical problem solving and images in clinical medicine series to the @NEJM?
Here’s the 1992 article introducing the images series nejm.org/doi/pdf/10.105…
And here’s the 1992 article announcing the new clinical problem solving series nejm.org/doi/pdf/10.105…
#GrandRounds @jpkassirer discussing the evolution of clinical analysis and problem solving, how physicians understand positive predictive value, etc @VinayPrasadMD @Jia_Luo
“Good medicine does not consist in the indiscriminate application of laboratory examinations to a patient, but rather in having so clear a comprehension of the probabilities of a case as to know what tests may be of value” 1978 nejm.org/doi/full/10.10…
And updated more recently. jamanetwork.com/journals/jamai…
#GrandRounds @OHSUSOM @OHSUNews @Dadikoman very important lessons re legacy of the Tuskegee study + race & medicine-will tweet key articles
@Dadikoman 1978 Hastings Center Report, openly available HT @Harvard @oscharvard dash.harvard.edu/bitstream/hand…
@OHSUSOM @OHSUNews @Dadikoman this was the first research study to come out from the early years on the Tuskegee study, 1936 @JAMA_current jamanetwork.com/journals/jama/…
#GrandRounds @Jgold10529Jeff the "zebra" v "horse" case analysis was really educational, so sharing more details...
@Jgold10529Jeff #GrandRounds respiratory illnesses (upper & lower) common in Tanzania (not all TB)...why?
