Anencephalic

research assistant

[Anencephalic @Rxdeepdives]

@yusuf_mahatt True Doc "Diseases don't read Text Books" Very Important to avoid ruling out some diagnosis based solely on typical presentations

[Anencephalic @Rxdeepdives]

@DiscussingFilm @scratchy_scrap Seems like we are getting an action packed season after the slop that was season 2

[Fabrizio Romano @FabrizioRomano]

🚨📈 OFFICIAL: TOTTENHAM ARE STAYING IN PREMIER LEAGUE.

[Dr. Chacón-Lozsán F .'. @franciscojlk]

💊 “7 days of antibiotics” for community acquired pneumonia may soon become another example of medical inertia.

The study evaluated hospitalized non ICU CAP patients who:
✅ received 3 days of antibiotics
✅ became clinically stable by day 3
✅ had no severe immunosuppression or major complications

Patients receiving:
• short therapy (3 to 4 days total)
were compared against
• longer therapy (≥5 days)

Key finding:

⚠️ Outcomes were remarkably similar.

Short course therapy showed no major difference in:
• mortality
• readmission
• urgent care visits
• C. difficile infection

The adjusted mortality RR was: 0.89 (95% CI 0.01–2.25)

Importantly, mortality was extremely low in BOTH groups.

But perhaps the most interesting finding was not about antibiotics.

It was about patient selection.

📊 Out of 55,517 hospitalized CAP patients, ONLY 10.1% fulfilled strict eligibility criteria for ultra short treatment.

This highlights a critical real world problem in antimicrobial stewardship:

Evidence often applies to a far narrower population than we assume.

The majority of CAP inpatients were excluded because of:
• COPD or structural lung disease
• immunosuppression
• organ dysfunction
• anti Pseudomonas/MRSA therapy
• instability by day 3

So while shorter therapy appears safe in carefully selected stable patients, the evidence gap remains enormous for:
⚠️ frail elderly
⚠️ immunocompromised patients
⚠️ severe CAP
⚠️ persistent hypoxemia
⚠️ ICU populations

📉 Antibiotic duration should be physiology guided, not calendar guided.

Clinical stability mattered more than arbitrary duration:
• afebrile
• stable BP
• no tachycardia
• stable oxygen requirement
• normal mentation

This is probably the future of inpatient infectious disease management: individualized, physiology driven therapy duration.

Not: “complete 7-10 days because that’s what we always do.”

Another very strong methodological point:

🧪 The study used target trial emulation methodology.

This increasingly important epidemiological framework attempts to reproduce the rigor of randomized trials using large observational datasets while minimizing immortal time bias and confounding.

We will likely see this methodology used more frequently in:
• antimicrobial stewardship
• ICU medicine
• perioperative medicine
• real world effectiveness research

My main takeaway:

⚠️ We probably overtreat many stable CAP patients.

But We still lack sufficient evidence for the complex, fragile, comorbid patients we see daily in real world internal medicine and ICU practice.

That distinction matters enormously.

📖 Doumat G, Ratz D, Horowitz JK, et al. Short Versus Longer Antibiotic Duration for Community Acquired Pneumonia: A Multicenter Target Trial Emulation. Annals of Internal Medicine. 2026.

[Anna @tokkianami]

My favourite moment from last night was when the audience at the Royal Albert Hall, including Prince William, sang ‘Happy Birthday’ to Sir David Attenborough 🎶🥹💚

[Anencephalic @Rxdeepdives]

@wildflower_2 This season has been turned into a marketing campaign for vought uprising, relegating butcher to a side character is genuinely insane

[The Independent @Independent]

Sir David Attenborough responds to 100th birthday greetings

[Anencephalic @Rxdeepdives]

Re the final season of the boys: The resurrection of soldier boy has derailed the momentum of the show. The emphasis on the father son dynamic overshadows what should be an epic conclusion. Butcher is at most a side character rather than the center piece of the story!

[Anencephalic @Rxdeepdives]

I enjoyed this season of daredevil , sometimes it's necessary to take things as they are as opposed to what you wish they were. Don't romanticize the past wasting time drawing comparisons to the original show. Looking forward to the next season #daredevilbornagain

[Anencephalic @Rxdeepdives]

Although this fight for survival is mostly self-inflicted, if De Zerbi can somehow avoid relegation given the prevailing conditions , he at least deserves a statue!

[DØÇTÖR CRUÏS£ @ThatCruiseMedic]

My surgery viva question:

Prof: Congratulations doc, you are already a house officer, but let me assume you are my HO on call and 4 hours after we did thyroidectomy, the nurses drew your attention to the fact that the patient was having difficulty in breathing and Spo2 was dropping.

You checked and noticed that the neck was very tensed, what is the single most important thing that you will do to keep the patient alive before I arrive?

Guess the answer🫣

[Anencephalic @Rxdeepdives]

@iankiplangat01 Is it crazy to think arteta might have a chance, this is comical defending

[Anencephalic @Rxdeepdives]

@iankiplangat01 Why is harry kane dropping into midfield?

[Anencephalic @Rxdeepdives]

@iankiplangat01 Seems like kompany is indeed pep's student, making the same mistakes on big UCL games

[Anencephalic @Rxdeepdives]

@iankiplangat01 @SpursOfficial It is no longer in our hands either way this squad has finished 17th in consecutive seasons

[Anencephalic @Rxdeepdives]

@iankiplangat01 @SpursOfficial We will finally get the opportunity to have the rebuild we have avoided ever since Poch left. Get rid of all these players and sign players willing to fight for the club

[Anencephalic @Rxdeepdives]

@WardReflections @amerix Dr. Barry Marshal literally infected himself with hpylori to prove this concept and won a nobel price for his achievements. But influencers will tell you no the test is a scam. The beauty of the social media! Diet is important but so is evidence based medicine.

[Anencephalic @Rxdeepdives]

@dunemovie I find it interesting that less than 1% of moviegoers have seen these films the way they were intended in IMAX 70 mm with a 1.43:1 aspect ratio. I unfortunately do not belong to this esteemed demographic. Perhaps that will change soon @scratchy_scrap

[Anencephalic @Rxdeepdives]

@ruth12795557 @DrGithiria O is a recessive gene can only be expressed in the homozygous state so it's not possible to get AB if both parents are O

[Anencephalic @Rxdeepdives]

@westerosies @scratchy_scrap The kind of pettiness I can get behind😂