Vero Coguox González

M y C/Internal Medicine/Infectology resident

[Memodi @MemodiApp]

Metas glucémicas en diabetes gestacional:

- Glucosa en ayuno <95 mg/dL
- Glucosa 1 h postprandial <140 mg/dL
- Glucosa 2 h postprandial <120 mg/dL
- HbA1C <6% (<7% si no puede lograrse sin hipoglucemia)

ADA Standards of Care 2026

[Oliverio @LuisOliverio]

Mantener el ritmo de todo lo que sale de Medicina es... apabullante.

Pero ya está el tema de Bacteriemia por Staphylococcus aureus, totalmente reestructurado con la nueva Guía de la IDSA 2026 en Accio (https://t.co/FQyQuLPcWG). En Español y con un algoritmo rápido interactivo.

Además:

🔵 Agregamos +1,000 casos clínicos y preguntas nuevas al Simulador ENARM y mejoramos toda la interfaz (https://t.co/oDIxUb0ar0).
🔵 En Junio corregimos y actualizamos cientos de temas en Memodi, Desde Anemia, Epilepsia, Dengue, choque séptico, edema agudo pulmonar, insuficiencia cardíaca, diabetes, tuberculosis.
🔵 Agregamos muchas muchas calculadoras a Calculus. FIB-4, SOFA-2, HOMA, PSI, FeNa, HEART, NEWS2.
🔵 En Accio, ahora intento que cada artículo relevante, esté actualizado pronto: hepatopatía asociada a alcohol, lumbalgia, IAMcEST, cefalea, dengue y más. Pronto hay una nueva actualización a la app.

No vamos a parar hasta hacer que @MemodiApp sea imprescindible para la Medicina en Latinoamérica. Si no lo han hecho: conozcan las apps (https://t.co/eEwHNUCNgx).

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

Staphylococcus aureus bacteremia guidelines recommend obtaining FUBCs every 2-4 days until bacteremia clearance!
🆕💥💥🟢 cohort study at two Dutch hospitals : Routine serial follow-up blood cultures after a negative result within 48 hours of MSSA bacteremia: low yield, high cost.
🔺Early Skip phenomenon in SAB was uncommon : Among 1005 included SAB patients, 31 patients had early SP (3.1%): In 27 of these (87%), clinical condition prompted repeat FUBCs. If one negative FUBC within 48 hours was considered sufficient, four patients (1%) without clinical triggers would have been misclassified as early clearance, potentially missing persistent bacteremia
🔺Clinically stable, afebrile patients without signs of metastatic infection and one negative FUBC within 48 hours have a very low risk of missed persistent bacteremia
🔺Potential cost savings from discontinuing FUBCs after one negative result within 48 hours were 13,513 USD per 100 patients #idxposts https://t.co/hh14NrwTin

[S.Enf.Infecciosas HRUM @infeccHRUmalaga]

En #InternJInfectDis ENS. CLÍNICO #ITUcomplicada (📸👇🏻)donde #meropenem 7 días🆚Meropenem 3 días ➕ #FosfoTrometamol día 4 y 6 en #Enterobacterales R CFP 3 Gen.👉🏻 MISMA curación clínica👌🏻y ➖estancia🏥📉
Opción para #DESESCALAR🪜💊y #AhorroCarbapenemes
🔗🆓https://t.co/WOZMC22sLQ

[Kohei Hasegawa @kbot13533737]

90日以内のステロイド暴露はカンジダ血症リスクを上昇させる- Clinical Microbiology and Infection (2026)

・デンマークのnested case-control study
・ステロイドは用量依存性にカンジダ血症発症リスクを高める
・30日、60日以内の感度解析でも同様の結果

https://t.co/O2gGuVe2zE

[Alí Sebastian Meza @AliSMV7]

🔺Osteomyelitis (Nature 2026)

https://t.co/nWAf4XLPhT

[S.Enf.Infecciosas HRUM @infeccHRUmalaga]

Cómo son los “nuevos” #antipseudomonicos BL/BLI❌🟢en #Pseudomonas R a #carbapenemes? #AntimicrobAgChemother 800 cepas🌍
💉Ceftol/Taz 31% R
💉Ceftaz/Avib 33% R
💉Imip/Releb 66%R
No en todos lsitios iguales resistencias👉🏻IMPORTANTE conocer TÚ 🫵🏻ecología
🔗🆓https://t.co/dIumkkdwrQ

[IDSA @IDSAInfo]

People with HIV (PWH) and cancer have greater cancer-specific mortality than patients without HIV. In @CIDJournal, authors describe the associations between low CD4 cell counts and cancer-specific mortality in PWH with cancer. https://t.co/6zjPY5gCFe

[Gabriel Puche, MD/PhD @gabi_puchepalao]

📢 Actualización clínica relevante sobre la bacteriemia por Enterococcus faecium (BSI), basada en un consenso Delphi internacional (ESGBIES).

⚠️Un microorganismo cada vez más frecuente y asociado a elevada morbimortalidad.

[Estudiando pal ENARM 2026 @ParaelENARM]

ESPONDILITIS ANQUILOSANTE

Resumen en una sola imagen !

#ENARM #ENARM2026 #ESPONDILITISANQUILOSANTE #EA #REUMATOLOGIA #REUMA #MI

[S.Enf.Infecciosas HRUM @infeccHRUmalaga]

Nuevo fármaco🆕🎉🥳 en #HepatitisBcronica🦠 @NEJM Ensayo Clin. F3 donde #Bepirovirsen (semanal y subcutáneo durante 24 semanas)💉 junto con #NoAnálogos (al menos 48 semanas) consiguió curación aprox 20% a las 72 semanas 👏👏👏 Buenísima noticia!📰👌🏻
🔗 🆓https://t.co/XQ6pSMh256

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

🆕💥🔴An updated meta-analysis and evidence map of systematic reviews
The efficacy and safety of inhaled antibiotics in the treatment of lower respiratory tract infection #idxposts
https://t.co/Dp9oizQ6gX

[Alí Sebastian Meza @AliSMV7]

Current State of the Fight Against Antimicrobial Resistance: What Are the Different Strategies for Tomorrow?

https://t.co/sfgA5qxSo4

[🦠 Dr. Ahmed Alanazi @o_o_dr]

DM2 treatment is not one drug for everyone 👀

📌 ASCVD → SGLT2i / GLP-1 RA
📌 HF → SGLT2i
📌 CKD → SGLT2i ± Finerenone
📌 Obesity → GLP-1 RA
📌 Very high A1C → Insulin

Simple DM2 approach with benefits & drug names 💉📚

https://t.co/4r50aAuxIN

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

Never underestimate the staph aureus!
A new case report in IDCP of MRSA right coronary artery aneurysm in a 56-year-old male with poorly controlled diabetes and recent complex MRSA bacteremia originating from a skin source #idxposts
https://t.co/FXvWCk2JuH

[Dr.Marlon Villanueva™ 🩺 𝕏 @MarlonVFZR]

🚨 𝗦𝗶́𝗻𝗱𝗿𝗼𝗺𝗲 𝗛𝗘𝗟𝗟𝗣: 𝗹𝗼 𝗶𝗺𝗽𝗿𝗲𝘀𝗰𝗶𝗻𝗱𝗶𝗯𝗹𝗲
⬇️⬇️⬇️⬇️

🩸 𝙃 = 𝙃𝙚𝙢𝙤́𝙡𝙞𝙨𝙞𝙨
* ↓ Hb → anemia
* ⚠️ ↓ transporte de O₂

🧪 𝙀𝙇 = 𝙀𝙣𝙯𝙞𝙢𝙖𝙨 𝙝𝙚𝙥𝙖́𝙩𝙞𝙘𝙖𝙨 ↑
* 🧠 Disfunción orgánica
* ⚠️ Riesgo de CID

🩹 𝙇𝙋 = 𝙋𝙡𝙖𝙦𝙪𝙚𝙩𝙖𝙨 ↓
* 📉 Trombocitopenia
* ⚠️ Alto riesgo de sangrado

💊 𝙈𝙖𝙣𝙚𝙟𝙤
* 🧠 𝙎𝙪𝙡𝙛𝙖𝙩𝙤 𝙙𝙚 𝙈𝙜 → prevención convulsiones
* 💉 𝘼𝙣𝙩𝙞𝙝𝙞𝙥𝙚𝙧𝙩𝙚𝙣𝙨𝙞𝙫𝙤𝙨 (hidralazina / labetalol)
* ⚠️ 𝘾𝙖𝙡𝙘𝙞𝙤 si toxicidad por Mg
* 👶 𝘿𝙚𝙛𝙞𝙣𝙞𝙩𝙞𝙫𝙤: 𝙥𝙖𝙧𝙩𝙤

🎯 𝘾𝙡𝙖𝙫𝙚𝙨
* ⚡ Evolución rápida
* 🧪 Monitor: Hb, AST/ALT, LDH
* 🤰 Prioridad: madre + feto

⚡ 𝙏𝙖𝙠𝙚 𝙝𝙤𝙢𝙚
👉 𝙃𝙀𝙇𝙇𝙋 = 𝙚𝙢𝙚𝙧𝙜𝙚𝙣𝙘𝙞𝙖 𝙤𝙗𝙨𝙩𝙚́𝙩𝙧𝙞𝙘𝙖 → 𝙚𝙨𝙩𝙖𝙗𝙞𝙡𝙞𝙯𝙖𝙧 𝙮 𝙩𝙚𝙧𝙢𝙞𝙣𝙖𝙧 𝙚𝙢𝙗𝙖𝙧𝙖𝙯𝙤

‼️Si te sirve: ❤️ Me gusta | 🔁 Repost | ➕ Follow para más👇🏼👇🏼👇🏼👇🏼

📚📖#ClubCrit👨🏻‍⚕️👨🏻‍🏫🧠🫶

#HELLP #FOAMed #FOAMcc

#ClubCrit #CriticalCare #CriticalCare #FOAMed #FOAMcc #CuidadoCrítico #MedTwitter #CritCare #icu #intensivecare #diagnosis #management #UCI #MedicinaBasadaEnEvidencia #MedEd #MedX #IntensiveCare #MedIntensiva #MedXCommunity #MedED #ICUmanagement #MustRead #LecturaRecomendada

[S.Enf.Infecciosas HRUM @infeccHRUmalaga]

Sabemos q #Gripe puede asociarse a #AspergilosisPulmonar(#IAPA)🦠🫁➡️🍄🫁 dado q entidad grave y alta mortalidad⬆️☠️… Damos profilaxis antifúngica en gripe en #UCI🛌💨? En @CMI_journal en 448 pac.:Profilaxis NO redujo IAPA y aumentó la hepatotoxicidad🤢
🔗https://t.co/nwos5rx8B1

[Leonardo Santos @Leo_Santo5]

🦠😷Diagnóstico Microbiológico de las Infecciones Respiratorias en Pacientes Inmunocomprometidos Criticos

🔰📚Seminars in Respiratory and Critical Care Medicine

doi: 10.1055/a-2808-5317

Enlace a Artículo Completo👇🏻✅🆓
https://t.co/xumUMHaxVK

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

▶️Optimising treatment of severe infections due to DTR organisms
Bookmark this table, everyone's favorite table!
#ESCMIDGlobal2026

[Dr sthanu subramanian @drsthanus]

Urine antigen tests (UATs).

Used for respiratory pathogens because they provide a rapid, non-invasive, and simple way to identify specific bacteria that are otherwise difficult or slow to culture.

These tests detect specific proteins (antigens) shed by pathogens like Legionella pneumophila and Streptococcus pneumoniae that are concentrated by the kidneys and excreted in urine.

*Key Reasons for Using UATs

1. Speed:

Results are typically available within 15–30 minutes, allowing for immediate clinical decisions compared to 48+ hours for traditional cultures.

2. Non-Invasive:

They require only a simple urine sample, avoiding invasive procedures like bronchoalveolar lavage or the difficulty of obtaining high-quality sputum from very ill patients.

3. Unaffected by Antibiotics:

Unlike cultures, UATs can often detect pathogens even after antibiotic treatment has started, because they look for bacterial fragments rather than living organisms.

4. High Specificity:

Most UATs have a specificity greater than 90–95%, meaning a positive result is a very strong indicator of the specific infection.

5. Targeted Treatment:

Early identification helps doctors switch from broad-spectrum "guesswork" antibiotics to narrow-spectrum therapy specifically targeting the identified pathogen, which improves patient outcomes and reduces antibiotic resistance.

https://t.co/5rvHY0oChV.

https://t.co/vvteQ1ejN8.