Mr. Garvin

“Indeed, no one finds a home here who does not intend to wage a war” | Internal Medicine/Pediatrics Resident |🇻🇦

[Mr. Garvin @garvs_72]

“When we look back, our eyes alight on graves and ruins, on a field of rubble. We are then inveigled by a mirage of time: while believing we are advancing and progressing, we are actually moving toward that past. Soon we will belong to it: time passes over us.”

[Mr. Garvin @garvs_72]

@PulmCrit This post has been fact checked TRUE by real fluid-disrespecting patriots

https://t.co/ZqYRoDhqSL

[Mr. Garvin @garvs_72]

Fluid enjoyers won’t tell you this but this was a positive trial

A therapy with identical efficacy and fewer adverse events is, in fact, superior

[Mr. Garvin @garvs_72]

“Well sir, you are very sick. Let’s engage in a shared decision making process to determine how to proceed”

Plan A: save your life

Plan B: the same as plan A except that I might randomly dump a bag of saline into your lungs for no reason because mommy (surviving sepsis campaign) says that’s what good boys are supposed to do

“I know this is a very difficult decision sir. Unfortunately the Best Available Evidence™️ simply doesn’t say which is better”

[Mr. Garvin @garvs_72]

Fluid enjoyers won’t tell you this but this was a positive trial

A therapy with identical efficacy and fewer adverse events is, in fact, superior

[Mr. Garvin @garvs_72]

Fluid enjoyers won’t tell you this but this was a positive trial

A therapy with identical efficacy and fewer adverse events is, in fact, superior

[NEJM @NEJM]

Presented at #CCR26:

Among adults with septic shock, the use of restricted fluids and early vasopressors did not result in more days alive and out of the hospital through day 90 than the use of liberal fluids and later vasopressors. Full ARISE FLUIDS trial results: https://t.co/GsimTBtR7c

@CritCareReviews

[Mr. Garvin @garvs_72]

Anyone who posts things like this should be sentenced to 10,000 years of Groundhog Day as a market maker on October 19, 1987

This should be plenty of time to ponder the obvious and profound stupidity of a “20-sigma event”

[Ryan Detrick, CMT @RyanDetrick]

To put this in context, a 6-sigma event happens once every 4,030,00 years. 4 million years!

It happened a couple weeks ago 😁

[Mr. Garvin @garvs_72]

@anish_koka inb4 “our revolutionary drug slows disease progression and improves function by 3 points on a 73,929,817 point scale, and fewer than 10% of patients experience hepatic liquefaction or exploding kidneys”

[Mr. Garvin @garvs_72]

This is essentially not even possible (which is why they don’t specify how this was estimated despite saying that they reduced sepsis deaths by half)

Treating seriously ill septic patients with effective antibiotics reduces mortality by about half (~50% to ~25%) in retrospective studies that use patients with resistant bacteria as “controls” (since they were effectively not treated for at least 2-3 days until the cultures/sensitivities resulted)

This means that a hospital to reduce its sepsis mortality by half via “early recognition” it would basically have to go from:

A) not prescribing antibiotics to anyone for any reason until they have been hospitalized for 72 hours

To:

B) immediately ordering the correct antibiotic(s) for ~100% of patients with serious bacterial infections, including nearly perfect empiric coverage of resistant or atypical organisms

[Mr. Garvin @garvs_72]

If you believe this I have a bridge to sell you

[The Times and Sunday Times @thetimes]

Palantir software halves sepsis deaths at US hospital https://t.co/heFMTdxbQu

[Mr. Garvin @garvs_72]

@mean_field_zane @danielluo_pi It happened before AI

GPT did not initiate the slop tsunami, it merely accelerated it

[Mr. Garvin @garvs_72]

Expert respecters mogged once again

[CNN @CNN]

After the drastic change in guidance to no longer keep allergenic foods away from babies until 1 to 3 years of age and instead introduce them by 6 months of age, the prevalence of egg allergy among children fell by more than 17% in a new study published Monday in the journal JAMA Pediatrics. https://t.co/DAYqlFom8N

[Mr. Garvin @garvs_72]

@jasonryanmd I always laugh when they take the M3s out of their rotations for a sim

Brother they were literally here seeing real patients and now they have to go see fake patients

[Mr. Garvin @garvs_72]

@cremieuxrecueil Lmao

Reminds me of the people who claimed that metastatic colon cancer was skyrocketing because colonoscopies were interrupted for 1-2 years during COVID

[Mr. Garvin @garvs_72]

The peds attendings are making me order PRN blood pressure meds on an adult

[Mr. Garvin @garvs_72]

It should be kept in an underground vault guarded by armed pharmacists and an ID fellow with a rusty machete

[Conrad Fischer @SeeFisch]

The world's FIRST oral CARBAPENEM!
Sulopenem

Greater activity than meropenem or ertapenem against gram-positive bacteria (e.g., Enterococcus faecalis, Listeria monocytogenes, methicillin-susceptible Staphylococcus aureus, Staphylococcus epidermidis)

MAINLY URINARY GRAM NEGATIVES

[Mr. Garvin @garvs_72]

OPEN THE CONTINENT

STOP HAVING IT BE CLOSED

🇺🇸 🇺🇸 🇺🇸

[Military History Now @MilHistNow]

RIGHT NOW in 1944, the first of 20,000 Allied paratroopers are dropping into Normandy. The long-awaited liberation of France is underway.

[Mr. Garvin @garvs_72]

This would de-standardize the exams, which is basically the exact opposite of what every stakeholder in the entire system wants

Any potential benefit simply does not matter compared to this

Also, there are ways to game the current system (see the recent NBME cheating scandals) but can you even imagine the arms race for learning how to punk the AI lmao

[Mr. Garvin @garvs_72]

@PunishedGobl1n F

[Mr. Garvin @garvs_72]

GOOD MIDWAY MORNING

[Military History Now @MilHistNow]

On this day in 1942, U.S. warships ambush a Japanese task force at Midway. Japan loses four carriers and nearly 250 warplanes in the ensuing battle. It's a turning point in the Pacific War.

[Mr. Garvin @garvs_72]

@mean_field_zane Please refer to Saieh by its proper name (The Money Church)

[Mr. Garvin @garvs_72]

Severe, untreatable, progressive neurodegenerative disease

[ShitpostGateway @ShitpostGate]

What happens if he trips and falls?

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

@nikillinit No. We are not public health officials. We are doctors.

If everything is healthcare then nothing is.