Colin C

[Colin C @doc_ccc]

Extraordinary slide from Milton Packer's wonderful lecture 🤯

What a time to be a #HeartFailure specialist... we just need a lot more of us (doctors, nurses and AHPs) to deliver all the therapies at our disposal.
#GDMTworks #BSH2021 #BSHAM2021

[John Gillespie 🌱 @DrGillespie_GP]

Some geritricians and AE docs will often tell all about the harms of overprescribing they see every day. IMO, problem is they have selection bias- they are more likely to see the patients who have side effects. Yes overprescribing can be a problem - but the reflex of stop the statin or antianginals or GDMT in HF could well lead to harm for many patients.

For the secondary care deprescriber they may well also see a nocebo effect that is then misattributed, but never see the stroke that happens in community to the 80 yo that could have been avoided, or the worsening angina or the readmission with decomensated heart failure. Give GPs funding and time and we can prevent inappropriate prescribing.

[Colin C @doc_ccc]

@AndrewJSauer Threshold drugs, or just differing magnitudes of effect between individual people?

https://t.co/UAAn8gkrYc

[Colin C @doc_ccc]

@DariusChapman If you get lead entanglement you can use the diathermy 'trick' to free up the helix from entangled tissue. Only used it once in clinical practice, but it worked well @CPearman_EP

https://t.co/OHqChUePTD

[Colin C @doc_ccc]

@TheTilehurstEnd Getting the ball forward much quicker than last season

[Colin C @doc_ccc]

@AnilMakam @drjohnm What medical therapy is 'guideline-directed' in this situation?

[Colin C @doc_ccc]

@donsin4 It's not a negative trial. It's a neutral trial.

[Colin C @doc_ccc]

It's the first time EVER that the UEFA Conference League final is between teams from two different capital cities...

[EuroFoot @eurofootcom]

It's the first time in 55 YEARS that the UEFA Champions League final will be between teams from two different capital cities.

Arsenal (LONDON) vs PSG (PARIS)! 🏴󠁧󠁢󠁥󠁮󠁧󠁿🇫🇷🥵

[No Context Brits @NoContextBrits]

David Attenborough is officially too old to play with Lego.

[Colin C @doc_ccc]

@mmamas1973 @nolanjimradial By the end of the video they look exactly the same. Presumably the difference is only noticeable for the first few sips.

[Colin C @doc_ccc]

@jasonryanmd Perhaps Tom Jones should have called his hit song "It's Usual", rather than "It's Not Unusual"...?

[Colin C @doc_ccc]

@modeofg @pott95 Glenn Murray

[Dr Chris Monkhouse @chris_monkhouse]

ATP fails for three distinct reasons. Understanding which one and why is where the real EP fun starts.

#Electrophysiology #ICD #VentricularTachycardia #BHRS #HRS #EPeeps

[Colin C @doc_ccc]

@DrMarthaGulati They just follow the algorithm
https://t.co/OaUm79DVWY

[David Warriner @DrDavidWarriner]

Absolutely genius. An ECG guideline for surgeons....

[Colin C @doc_ccc]

@PhilDurkin3 The most frustrating situation is the the patient who has likely entered the last year of their life, where the minimum is <1 month, but the estimated is e.g. 14 months...

[Colin C @doc_ccc]

@mancunianmedic I expect he really did mean Doublebase

[Colin C @doc_ccc]

JF(K)DI

[@DrKatie.BSky.Social @doctor_katie]

Says it all….

[Colin C @doc_ccc]

@TheTilehurstEnd 7/10 for Pereira... seriously, what do you have to do to score 8, 9 or 10?

How can Joel have been rated only 2 points higher than MO'M??

The scale runs from 0 to 10. Yet it seems very rare for anyone to be awarded <5 or >8, now matter how terribly or amazingly they play!

[Colin C @doc_ccc]

@jtsaxon 'Extreme' doesn't work, as the extreme of a scale implies the end of the scale, i.e. there can't be a higher grade.

Why not just call it Grades 1, 2, 3, 4 & 5?

[Colin C @doc_ccc]

@DrDavidWarriner @Heart_BMJ @sumitku3007 Very interesting ECG finding, but what an utterly bizarre way to write up a case. Why would you do blood tests and an echocardiogram before doing an ECG in someone presenting with syncope and a heart rate of 25 bpm? 🤔

[Colin C @doc_ccc]

@cardiacpolymath 16 is the correct answer