Patient safety and systems expert and ID specialist trying to lead change. Suffered an AKA from a surgical error 2012. Textbook author, Opinions my own
Check out Dr. Fred's video! Healthcare in the US is no longer affordable. 4/10 of Americans have significant medical debt. Stand up and get involved. #TikTok https://t.co/fk7vUCnOfg
@BrownJHM Bartonella henselae commonly carried in the claws of kittens. We see cat scratch fever frequently in Florida. The first large series of cases was reported by a physician in Jacksonville FL.
@anujtiwari11 I also recommend the app Bayes’ post-test probability free app for iPhone also available on MedCalX. Enter your estimate of the disease pretest probability and the specificity and sensitivity of the test to determine the value of ordering each specific test.
@spartacus_real I am so impressed with all you are doing. You are the ideal student. You take the information and run with it. Great job. I am so proud. That’s why I created the course. To make a difference. You are making that dream come true. Thank you
FYI: Anyone can send a report into VAERS after vaccination. Some reports may be true adverse reactions, or they may be coincidental and not related to vaccination.
Florida’s surgeon general draws wrong conclusions from COVID data in his vaccine warning https://t.co/MzEpW7PxEB
@spartacus_real Thank you for taking the course and for sharing the real facts. I agree South Korea has been one of the best examples of how to responsibly manage the pandemic. Keep spreading the truth.
@okwalding ID specialist save lives, shorten hospital stays, and prevent hospital from being overrun by MDR bacteria. They save our health systems money. The present reimbursment system fails to reward cognitive work rewarding procedures. Further evidence of US healthcare dysfunction.
@MayoClinicINFD Vibrio vulnificus. We see this pathogen all too frequently in Florida, particularly after hurricanes when the victim wades throughout brackish water and has a cut. The infection mimics group A Strep in its speed of spread and fulminant course.
@BrownJHM Treponema pallidum enters the skin forming an ulcer usually on the penis of males. The ulcer is clean-based with minimal tenderness. Over the next 2-10 weeks the spirochete disseminates as shown in your images. 2ndary syphillis has been called the great imitator.
A rational approach to masking. COVID-19 promises to be with us for many years. Also masks protect against other airborne infections. Many upsides no real downsides.
With few mandates, masking decisions have become more complex, blending covid prevalence, personal risk, risk to others, risk attitudes, vax status, social pressure, & exhaustion. @MorningEdition@NPR, I weigh in, along with Wm. Schaffer & @MonicaGandhi9.
https://t.co/HFY8UCy5jW
@BrownHospMed Red man syndrome caused by histamine release. You need to slow down the infusion rate. Better yet switch to ceftaroline. This 5th generation cephalosporin binds the PBP2 binding protein of MRSA with high affinity and is cidal.
This up to date review of the side effects of the vaccine, duration of protection, the need for boosters and the differences in efficacy between monovalent and bivalent vaccines in SARS CoV 2 Vaccination Part 3 (updated 1-28-23) https://t.co/gaeowd5WTo via @YouTube
@BrownHospMed Primary EBV infection. I suspect she also has diffuse adenopathy and splenomegally. Exudative tonsillitis can mimic group A stretococcus. Heterophile antibody is the test of choice.
@BrownHospMed Peritonsilar abscess is most likely. Critical to treat quickly because infection can spread to the “danger zone” a fascial plane that allows spread to the mediastinum and can result in purulent pericarditis.
@BAshbyMD Listened I last night. When it comes to the analysis of vaccines this is a very specialized field with many variables. Physicians not schooled in these methods can misinterpret the data. Dr. Paul Offit is world a renowned and independent expert https://t.co/I3lDL9KdpW
#COVID19 There has been some confusion with regards to the efficacy of the bivalent booster vs the monovalent booster. Serum neutralization differences of 4-fold or less are not significantly different for protection. Bivalent and monovalent are equivalent https://t.co/I3lDL9JFAo
@BrownHospMed @Radiopaedia Temporal lobe edema associated with focal weakness could be due to herpes simplex encephalitis but there should be headache, fever and confusion CSF pcr is the test of choice. Meningovascular syphilis is also possible. FTAabs should be ordered. Finally SBE with a septic embolus.
I agree! Please watch these videos on antibiotic treatment basics. If everyone followed these rules we could prevent the selection of multi resistant bacterial (MDR). We can all help prevent the “end of the antibiotic era” https://t.co/rIHCbX2HXn
Less is more - ID perspective
1. De-escalation
Broader spectrum of activity doesn't mean better efficacy
E.g. MSSA
Cefazolin or anti-staphylococcal penicillins are better than vancomycin or ceftriaxone
It's okay to start broad, but remember to de-escalate when feasible