Alan Méndez T

[心臓外科医K.M @a_cardiac_md]

二重に縫うと時間がかかるように思えますが、止血針を減らし結果的に時間を減らす場合があります。

解離や、ベントールのLMTの後壁などで使用すると特に効果を発揮するので試してみる価値はあるでしょう。

[PleuralPOCUS | Dr. Jaime Sánchez @PleuralPOCUS]

Serie ADAPT-3 de desescalada de dosis de tPA/DNase intrapleural:

n=100 pacientes consecutivos no seleccionados con infección pleural tratados con 1 mg de tPA/5 mg de DNase intrapleural 2 veces al día como dosis inicial.

El 94% fueron tratados con éxito. El 28% requirió escalada de la dosis de tPA debido a drenaje mínimo y/o sepsis persistente; 26 fueron tratados con éxito y 2 requirieron cirugía. Uno (1%) presentó sangrado pleural. #MedEd

[PleuralPOCUS | Dr. Jaime Sánchez @PleuralPOCUS]

7 años en proceso! Encantado de ver la 4ª edición del Textbook of Pleural Diseases en nuestras manos con nuevos co-editores @Nickmaskell1 @dfellerk + en memoria del Dr. Richard Light, quien editó las últimas 3 ediciones conmigo. Gracias a Shivangi Pramanik (CRC Press), quien supervisó la producción. ¡El libro a la venta el próximo mes!

[Bill Ackman @BillAckman]

An excellent and insightful report on $HHH.

[Gianluca Torregrossa @GianTorre610]

🟢 Intraoperative Visualization of Coronary Grafts with ICG during CABG Learn how ICG can help assess graft patency and myocardial perfusion before leaving the OR. ICC–ISCAS LIVE 📅 Sept 19 | 8 AM EDT #CABG #ICG #CardiacSurgery https://t.co/xIlUI6roJ3

[Silvina Dell'Isola @silvina_jk]

❌ Peores ciudades de Inglaterra para VISITAR:

・Londres 🏴 (pagas una fortuna por todo)
・Birmingham 🏴 (gris y sin demasiado encanto)
・Bradford 🏴 (poco que justifique el viaje)
・Luton 🏴 (el aeropuerto es lo mejor)
・Blackpool 🏴 (decadencia junto al mar)

✅ Ciudades de Inglaterra que SÍ merece la pena visitar ↓

[Igor Konstantinov @konstantinov_ie]

This a must to read by anyone interested in surgical management of hypertrophic cardiomyopathy.

[Seth McClung @Seth_3773]

Like him or not, this is how you hit. This guy hit for average and power.

Teach this type of hitting again and the game will be better. It will be more exciting, it will be a much better offensive product.

Thank you Alex.

[Леонид Коган 🇮🇱 @abuviktor1]

Есть песни, которые лучше вообще не трогать, потому что они уже настолько велики, что кажется: всё сказано до тебя. New York, New York, как раз такая.
И тут выходит та, кому не писаны никакие правила - Леди Гага. Без привычного поп-шоу, без попытки устроить из песни собственный аттракцион. Просто выходит и поёт. И через несколько секунд ловишь себя на мысли: а ведь она действительно понимает, что поёт. Не пытается переплюнуть Синатру, не копирует его, не превращает песню в современную поп-версию. Она просто берёт эту старую, почти вечную вещь... и на какое-то время делает её своей.
Потому что Гага вообще-то могла бы спеть её как угодно, но здесь... ей не нужно ничего доказывать - есть голос, есть оркестр, есть Нью-Йорк... И всё.
А дальше уже хочется просто слушать.
Меня сегодня мало кто впечатляет, как когда-то Элла Фицджеральд, Дюк Эллингтон, Хэнк Уильямс, Рей Чарльз. Но Леди Гага... Мне нравится, как она полностью отдается песне, радует невероятным голосом... Можете придать меня анафеме, но её исполнение "Нью-Йорк, Нью-Йорк" - это тоже классика.

Lady Gaga - New York (Live at Westfield)

[Robbie Hyde @gingersnaphyde]

This is genuinely one of the most amazing things I’ve ever watched in a baseball game. Not just throwing an immaculate inning, but also knowing it, smiling at it, and laughing after he did it.

Payton Tolle can’t be real, man.

[Ali Tekin @alitekintr]

TIME dergisinin seçtiği, hayatınızda en az bir kez okumanız gereken 100 roman. Kaydedin lazım olur.

[Jeff Passan @JeffPassan]

This is Kaima Taira. He is 5-foot-8, 220 pounds and throws up to 100 mph. He also might be the best starting pitcher available this winter outside of Tarik Skubal. More on him, Teruaki Sato (the class’ best hitter) and Hiromi Itoh: https://t.co/cOHKPO8tDn

[LBaddour @LBaddour1]

Infective Endocarditis: Diagnosis, Antibiotic Therapy, and Management: A Scientific Statement From the American Heart Association | Circulation https://t.co/x5gB7OpKl7
❤️‍🔥 Congratulations Dan and colleagues. #AHA @MayoClinicINFD @MayoClinicCV

[Elad Anter @EladAnter]

🔥 Hot off the press: We identified how and where AF begins.

I am excited to share this work.

Since the discovery of PV triggers more than 25 years ago, AF ablation has evolved into an empiric therapy centered on PVI. Yet, we have never been able to identify the arrhythmogenic substrate that determines why a premature beat initiates AF at one site and not another.

We believe this study changes that.

In this mechanistic study, we found that AF initiation arose predominantly through reentry originating from a small number of spatially discrete regions with steep repolarization gradients. Their distribution was unique to each patient, and they accounted for more than 92% of AF initiation episodes.

Importantly, the arrhythmogenic substrate was not defined by low voltage, and while conduction abnormalities were often present, they appeared to play a secondary role.

Its patient-specific distribution may help explain the controversy surrounding posterior wall isolation: the posterior wall harbored the substrate in only approximately 30% of patients. Importantly, in redo patients with durable PVI, right-atrial substrate (which is often beyond standard mapping strategies) was identified in 30%.

Most encouragingly, in an exploratory cohort of 24 patients with recurrent AF and durable PVI (50% PerAF), targeted elimination of these sites achieved 87.5% single-procedure freedom from any atrial tachyarrhythmia over a median of 489 days, without antiarrhythmic drugs.

The thoughtful accompanying editorial by Jon Kalman highlights the significance of this discovery and its central translational challenge of bringing it into real-world clinical practice.

But stay tuned! Technology is under development to transform this discovery into a rapid, automated functional mapping.

Current electroanatomic mapping relies largely on voltage amplitude and activation timing. We need to move beyond these measures and map how tissue actually functions - how it conducts, repolarizes, and responds to premature stimulation. This can add the critical dimension that has long been missing from substrate mapping and may reveal what truly makes cardiac tissue arrhythmogenic.

To me, this is the beauty of physiology: there are no black boxes. We can identify the sites that reproducibly initiate the arrhythmia, define their EP properties, eliminate them with ablation, and confirm that arrhythmia can no longer be initiated.

The next steps are prospective multicenter validation and technological development. Together, they may move AF ablation beyond empiric therapy toward truly individualized, mechanism-guided therapy.

📄 Paper in @JACCJournals:
https://t.co/izIR8HbNYk
📝 Editorial:
https://t.co/mYIilXkjJ7

#JACCCEP #AtrialFibrillation #CardiacElectrophysiology #CatheterAblation #EPeeps

[ISMICSofficial @ISMICS]

The ISMICS 2027 Call for Abstracts is open!

30th anniversary meeting. Edinburgh. May 26–29, 2027.

Five categories. One deadline: November 6, 2026.

Your work belongs there. 🔗 https://t.co/oSVO2O0ncb

#ISMICS2027 #CallForAbstracts #CardiothoracicSurgery

[Jerry Romine Stocks @Jerry_Romine_]

1 year ago $BE was $20 → ripped 1800% to $351.
Here are 13 stocks still under $20 with the exact same AI setup:

1. $POET $7.92 – Optical interposers for AI data centers
2. $LAES $2.42 – Post-quantum security chips
3. $TE $4.60 – Only US-owned solar cell fab
4. $KEEL $3.47 – Bitcoin miner turning AI power landlord
5. $SATL $4.64 – Owns the satellites, defense demand exploding
6. $ONDS $7.62 – Counter-drone defense
7. $ACHR $5.76 – Bought Boeing’s drone unit
8. $SMR $9.70 – Only NRC-approved SMR, AI needs baseload
9. $GILT $10.12 – Ground terminals for every constellation
10. $SPIR $11.98 – NOAA privatizing weather data
11. $GLXY $26.33 – Crypto funding gigawatt AI data center
12. $BKSY $20.50 – Gen 3 satellites live
13. $AEVA $15.69 – Lidar pivoting to AI co-packaged optics

Bookmark this. Which one are you watching?

[PleuralPOCUS | Dr. Jaime Sánchez @PleuralPOCUS]

12/ En resumen:

• La validación independiente sigue siendo el cuello de botella
• Líquido pleural por encima de plasma
• La IA está reescribiendo qué medimos
• Entre catéter y talco decide el paciente
• El ecógrafo, antes de la aguja

#ERS2026 #MedicinaPleural #POCUS

[ELSO @ELSOOrg]

📖 Blue book chapter 27 focuses on medical complications, offering strategies to anticipate, detect, mitigate these in #ECMO
🩸Bleeding/thrombosis, hemolysis, thrombocytopenia
🧫 Infections
🦵🏻Limb ischemia
🫀 Tamponade
🫁PTX/hemothorax
🫘AKI
🧠 Seizures
🛒 https://t.co/oDgLIvLJp3

[Marina Boschi. @MarinaBoschi3]

Nació en Kiev.

En sus páginas de esta novela, el diablo termina pareciendo más ético que buena parte de la sociedad que lo rodea.

Y décadas después, esa obra inspiraría “Sympathy for the Devil” de The Rolling Stones.

[Critical Care Reviews @CritCareReviews]

Vasoplegia in Cardiac Surgery and Mechanical Circulatory Support: From Cardiopulmonary Bypass to Advanced Circulatory Support Devices

CCR Journal Watch
https://t.co/Sp06oA6IDG