Boris Boskh

MD, Intensive Care; Internal Medicine💫

[Boris Boskh @BBoskh]

Photoskop visual learning: new way to learn photography https://t.co/YkAVfT6Jqn через @photoskop_proj

[Boris Boskh @BBoskh]

@pgMedicine Hypokalemic periodic paralysis due to renal potassium wasting (likely distal RTA/Gitelman syndrome). Plasma renin and aldosterone levels. Diff Gitelman syndrome.
Bartter syndrome.

[Boris Boskh @BBoskh]

@Paul_Wischmeyer Berofe Coronary inteventions era it was very common.

[Boris Boskh @BBoskh]

@Paul_Wischmeyer MI, Rupture and tamponade

[Boris Boskh @BBoskh]

@strange_pulsar @DocPriyamMD You can use Ganzoni formula to calculate the dose of IV iron.

[小谷祐樹 Yuki Kotani｜集中治療医 @YukiKotani5]

重症患者の気管挿管における循環動態の総説が、編集後のPDFとして見られるようになりました！
全文フリーでダウンロードできます👇
https://t.co/1ZMg6PdKBH

[Boris Boskh @BBoskh]

@DrPharmDMDTh Dark left side means air. No visible lung structures. No mediastinal shift. So its not a PTX or Bulla. Post pneumonectomy X ray

[ApoThera - Clinical Decision Support - Mobile App @ApoThera]

Updated Guidelines for Treatment Initiation of Restless Legs Syndrome
https://t.co/5cgYPqTb42
#MedTwitter #InternalMedicine #USMLE #neurologie #PrimaryCare #Medicina #MédecineInterne #MedStudentTwitter #Médecine #hcsm #hcsmeu #Hospitalist #UrgentCare #NeuroTwitter #Neurologia

[Thoracic Anaesthesia Group at Guy’s, London @ThoracicAGuys]

After years of working in thoracic anaesthesia, there comes a moment when you realise the gap between what you were taught and what you actually need to know.
For me, that gap was in One Lung Ventilation.
It's one of the most technically demanding parts of our practice, yet for a long time, dedicated teaching just wasn't there. So I made it my mission to change that.
l've spent years teaching and building resources for anaesthetists, ODPs and cardiothoracic teams at all stages of their careers to pave the way for confident, well-prepared clinicians. Because when the teaching is right, better outcomes follow.
That's why I built the FREE ONE-LUNG UK tutorial series.
You can already watch the teaser videos now on https://t.co/k07z3QmzGj https://t.co/YiUmc16g8f
The full chapters drop this Thursday.
And if you want hands-on experience, join us for the live ONE-LUNG UK course on 29th May at Guy's Hospital.
More info
& https://t.co/6yCzcTFWnw
#OneLungVentilation @GSTTanaesthesia

[Boris Boskh @BBoskh]

@DavidACohen3 Erythema Ab Igne

[Boris Boskh @BBoskh]

@modernHealthMe Post-hangover facial puffiness may be related to ADH imbalance; evaluation should include TSH testing

[Mukund Iyengar @mukundiyngr]

Cancer used to be a death sentence.
Now many are >90% survivable.

Childhood leukemia: 5% → 92%
HER2+ breast: 25% → 90%
CML: 22% → 87%

This is not "luck".
Its decades of funding towards time & infra that compounds discovery.

Pancreatic cancer today is the breast cancer of 1985, and Glioblastoma ≈ leukemia of 1970.

The scientists who will solve them
are already in labs NOW.

The question is whether we fund them long enough.

Funding doesn’t just support science.
It literally rewrites outcomes.

This plot is proof.

Source: SEER + NIH via @Jori_health

[Dr. Filippo Cademartiri @FCademartiri]

🏃‍♂️🫀 Exercise Prescriptions Should Be Risk-Stratified — Not Generic

Current guidelines recommend ≥150 min/week of moderate-to-vigorous physical activity (MVPA) for everyone.

But is that optimal for a 45-year-old low-risk individual and a 70-year-old very high-risk patient?

This large UK Biobank cohort (72,884 participants, median 13.2-year follow-up) provides a more nuanced answer  .

🔬 What’s innovative?
• Objective 7-day wrist accelerometer data
• ESC-aligned SCORE2 risk stratification
• Isotemporal substitution modeling (reallocating sedentary time)
• Identification of optimal vigorous activity thresholds by risk group

📊 Key findings
Each +150 min/week MVPA →
• 20% lower CVD risk in very high-risk individuals
• 16% reduction in high- and low-to-moderate-risk groups

Higher-risk individuals benefit the most from increasing activity.

BUT intensity matters.

When replacing 300 min/week sedentary time:
🔹 Low-to-moderate risk → Any mix of moderate (MPA) and vigorous (VPA) works. More VPA = more benefit.
🔹 High risk → VPA should be ≤60 min/week (~20% of MVPA).
🔹 Very high risk → Optimal VPA ≈ 42 min/week (~14% of MVPA). Beyond that, benefits decline.

In high-risk groups, excessive VPA may attenuate benefit—likely due to hemodynamic stress, endothelial dysfunction, and oxidative burden.

🎯 Take-Home Messages
1️⃣ Physical activity remains powerfully protective across all risk strata.
2️⃣ Higher-risk patients gain the largest relative benefit.
3️⃣ Vigorous exercise has a ceiling effect in high-risk individuals.
4️⃣ Exercise prescriptions should integrate formal risk stratification (e.g., SCORE2).

Precision prevention now extends to lifestyle medicine.

One size does not fit all.

[Boris Boskh @BBoskh]

@akafaceUS "Removing the stone of stupidity" by Hieronimus Boskh in real life 🙂

[Boris Boskh @BBoskh]

@KrimeeraPharma administered together glucose and Insulin interrupts ketone production

[Keith Siau @drkeithsiau]

80% of the diagnosis is in the history,
80% of the examination is in the inspection.

[Boris Boskh @BBoskh]

@drkeithsiau @omityah CPR-associated PTSD has their own soundtracks.

[Boris Boskh @BBoskh]

@drkeithsiau @omityah Eminem – “Lose Yourself” (100 BPM), ABBA – “Dancing Queen”, Ed Sheeran – “Shape of You” (96–100 BPM). also good choice

[Boris Boskh @BBoskh]

@Paul_Wischmeyer Hypertensive encephalopathy probably. IV Clonidine +IV Metoprolol . Aim to lower SBP to 160, Check history for amphetamines, cocaine. Check for papilledema.

[William Aird @WilliamAird4]

1/6

RETHINKING HEMOLYSIS CLASSIFICATION

I recently saw an incredibly rare but fascinating case of T-cell large granular lymphocytic (T-LGL)–mediated, DAT-negative hemolysis.

It prompted me to rethink how we classify hemolytic anemia and revise the schematic accordingly.