Pulmonary teaching case: you are called to the bedside of a 60yo man who was admitted for pneumonia a week ago. You were called because “he coughed and now his chest is PULSATING!”
This is what you see at the site of a previously removed chest drain:
What’s the diagnosis?
1/
ALT Lateral chest wall with pulsatile expansion.
ALT Linear probe POCUS image of chest wall showing fluid filled pocket which is expanding rhythmically.
How to set the ventilator during surgery? Key principles to guide intraoperative mechanical ventilation
CCR Journal Watch
criticalcarereviews.com/late…
We often take breathing for granted, but what if one day, those 23,000 breaths dwindled down to a desperate struggle for just one?
Don’t wait. Get vaccinated.
Because every breath is worth fighting for.
Breathe Strong, Philippines!
#WorldPneumoniaDayPH#WorldPneumoniaDay
It’s appropriate to step down once the patient is clinically improving (afebrile, hemodynamically stable, less/resolved SOB, & oxygen needs are decreasing) and/or they’ve completed a short, guideline-based (usually 5-7 days) course of antibiotics #PneumoniaChat
what if it's not pneumonia in the first place? Pneumonia vs Congestion is a frequent battle. we should also advocate for Abx stewardship across diff subspecialties #PneumoniaChat
A3: Use antibiotics wisely by 1) starting broad *only* when bacterial pneumonia is likely, 2) narrowing once cultures, antigen tests, and/or clinical data clarify the cause, & 3) stopping when the patient stabilizes, fevers resolve, & a 5-7 day course finishes #PneumoniaChat
Clinical parameters such as resolution of fever, improvement of symptoms: less cough, less dyspnea; decreasing O2 requirement are signs that the patient is improving. Recent studies show no add'l benefit with longer Abx tx duration: 5days should be enough #PneumoniaChat
Some literature mention Pressure Swing Adsorption plants in hospitals which is more cost effective than traditional cylinders. Available in the Philippines already! Could be useful in rural areas, govt hospitals #PneumoniaChat
So glad the pulse oximeter is more readily available at a low cost -- provides objective measure and guides patients re urgency and the need for higher level of care #PneumoniaChat
🦠💉 Two major Danish trials in >450k older adults:
Flu (DANFLU-2): High-dose vaccine ↓ influenza hospitalizations, but no added CV benefit
RSV (DAN-RSV): #Vaccine strongly ↓ RSV hospitalizations; CV effects modest, possible stroke signal
academic.oup.com/eurheartj/a…
Recently, the spirometry procedure for the flow–volume curve has been extended to add a forced complete inspiration after end of expiration, yielding the FIVC. A new acceptability criterion based on FIVC–FVC difference has been added as a quality check. bit.ly/44Cqz6v
🚨 New 2025 ATS guidelines on community-acquired pneumonia! Key points:
For stable adults with outpatient CAP, <5 days of antibiotics are recommended (minimum duration: 3 days).
Systemic corticosteroids for adults hospitalized with severe CAP.
doi.org/10.1164/rccm.202507-…
Today is #WorldNTMDay.
Raise awareness of NTM-PD with the latest original research on predictors of disease progression, published in the journal CHEST®.
Read the full article: hubs.la/Q03B8n5m0#MedEd#JournalCHEST
With @ProfJDChalmers, we're using machine learning and NHS data to spot early signs of bronchiectasis – helping GPs refer patients sooner for faster diagnosis and ultimately better outcomes.
@dundeeuni
ERJ: There is a significant test accuracy benefit of adding IGRAs to an active TB screening pathway, which will help inform clinicians and policy-makers on the most effective screening algorithms bit.ly/3EgtJ4R
🧵 Sjögren's Syndrome: The Doctor Whose Degree Was Denied — But a Disease Now Bears His Name
Ignored. Rejected. Forgotten.
Yet his idea changed medicine forever.
This is the story of Henrik Sjögren—and the disease we still miss today.👇
#MedTwitter#RheumTwitter