incidental finding

bro im tired

[incidental finding @incidental_fnd]

https://t.co/AnIuAPoGHt

[incidental finding @incidental_fnd]

@KoaWeb3 @grok analyze this gambling strategy, formalize it in words and then let's study a way to get it into a ctrader bot!

[Dr. Medica🩺 @DrMedica_13]

Did u know?

[Dr.カブ🫀 @UPto2Date]

Simple is best.

[おかめさん＠集中治療医 @okame_icu]

ESCガイドライン2026
decongestion management

概ね確立されつつあります。
エコーや尿中Naは重要な位置づけです。
心不全以外の重症疾患でも尿中Naをモニタリングしてみたいという隠れた野望があります。

①ループ利尿薬静注（フロセミド40mg、常用の場合は倍量）
②目標：2時間後の尿中Na≧70mmol/Lまたは6時間尿量≧100mL/hr
③達成しなければ倍量投与またはアセタゾラミド、ヒドロクロロチアジド
④目標2〜6時間後の尿中Na≧70mmol/Lまたは6時間尿量≧100mL/hr
⑤達成しなければループ利尿薬最大量まで増量、他の利尿薬追加を考慮
⑥最大限の利尿でも効果がなければ限外濾過を考慮

[Night Sky Today @NightSkyToday]

JUST IN🚨:Recent Study Finds Just One Minute of Anger Weakens the Immune System for 5 Hours.

[incidental finding @incidental_fnd]

https://t.co/AnIuAPoGHt

[incidental finding @incidental_fnd]

Stop using clocks for ADHD. Use endings instead.

A clock only works if you remember to check it — the exact thing that isn't happening.

So stop counting minutes. Count tracks.

Dishwasher — 1 track
Kitchen — 3 tracks
Laundry — 4 tracks
Chamber music works best: 2 to 5 minutes each, no lyrics, and every piece ends so clearly you feel it.
Music doesn't ask you to check it. It just ends.

Playlist ↓

#ADHD #chores

[NEJM @NEJM]

Presented at #ESCCongress:

Among patients with ST-segment elevation myocardial infarction and multivessel disease, physiology-guided angiography led to a lower risk of major cardiovascular events than conventional angiography-guided treatment. Full AIR-STEMI trial results: https://t.co/NcPWnhsoak

@escardio

[incidental finding @incidental_fnd]

7/

So the move the exam and the creatinine both point to — cut the furosemide — is the one that makes congestive nephropathy worse.VExUS here doesn't tell you to double the dose. It tells you not to back off. One caveat that matters: VExUS is well established as a prognostic tool. Evidence that VExUS-guided therapy improves outcomes is still limited. Treat it as a signal, not a target.That's the whole value: not a target to chase, a wrong turn avoided.Illustrative composite case, not a real patient.

[incidental finding @incidental_fnd]

78F, HFpEF, AF, moderate Tricuspid Regurgitation, BMI 34. Discharged 8 days ago on furosemide 40 mg BD. Today: feels better. Down 4 kg. Ankles dry. Chest clear. BP 118/70.Creatinine 1.1 → 1.4.Everyone reads that as over-diuresis. Reduce the furosemide.POCUS says the opposite.

👇👇👇

[incidental finding @incidental_fnd]

6/ How to know if it's working

Stop guessing from weight and oedema. Measure natriuresis.HFA/ESC: spot urine sodium 2 h after an IV loop dose. Under 50-70 mmol/L, or hourly urine output under 100-150 mL over the first 6 h, means insufficient response — double the dose or add a second agent. Protocols escalate to around 200 mg furosemide equivalent before adding a thiazide.Mullens et al, Eur J Heart Fail 2019

[Medical Notes @A25ma22]

tuberclosis(TB) managment _ (uptodate -2026)

[incidental finding @incidental_fnd]

SVS visceral aneurysm guidelines, splenic artery:

Repair → >3 cm, demonstrable growth, symptomatic, any pseudoaneurysm, any size in pregnancy or childbearing age, portal hypertension, liver transplant candidate.

Observe → <3 cm, stable, asymptomatic. In observed series growth is minimal, around 0.2 mm/year.

Which is why 2 cm on this film is not reassuring on its own. It's reassuring only once you know who the patient is.

Chaer et al, J Vasc Surg 2020;72(1S):3S-39S

[incidental finding @incidental_fnd]

Chest X-ray for cough. The lungs are clean.

Then you look at the bottom left corner.

A ring of calcification, 5-6 cm, left upper quadrant.

Most people report "normal chest".

What is it — and does it need anything?

↓

[incidental finding @incidental_fnd]

Next step is not a repeat X-ray.

Ultrasound with colour Doppler first: flow inside the lesion means vascular, and that changes the urgency today. No flow points to a cyst.

One caveat worth knowing — a densely calcified wall casts an acoustic shadow. Ultrasound then tells you nothing about what lies behind it. That's the point where CT stops being extra radiation and starts being the only answer.

CTA confirms and sizes.