James R. Pellegrini Jr., MD

Advanced Endoscopy Fellow at NYP-BMH. Diplomate of ABIM. 🇮🇹🇲🇽 🩺

[James R. Pellegrini Jr., MD @jaypelly]

@DKSports @AroundTheFelt

[Netflix @netflix]

“I train like I’ve never won, and I compete like I’ve never lost.” — Eileen Gu

🎙️: On Purpose with Jay Shetty

[James R. Pellegrini Jr., MD @jaypelly]

@FeverUpdate @stoolpresidente start a new league with cc!

[James R. Pellegrini Jr., MD @jaypelly]

@FeverUpdate @stoolpresidente

[Patrick Bet-David @patrickbetdavid]

You don't become exceptional by avoiding chaos. You become exceptional by learning how to lead through it.

[Landon Thomas @sixfivelando]

“I need you to lock in… I believe in you but you got to want this moment.“

Coach: Eye contact, reaffirming confidence while giving criticism

Player: Eye contact, listening, responding

This is some good coaching and credit to the player being coachable!

[James R. Pellegrini Jr., MD @jaypelly]

@thatG2m What song is this

[Amazing Physics @amazing_physics]

This is a 1000-gram iron bar. In its raw form, it’s worth around $100.
If it’s turned into horseshoes, its value rises to about $250.
If it’s made into sewing needles, its value jumps to roughly $70,000.
If it’s crafted into watch springs and gears, it can be worth around $6 million.
And if it’s transformed into precision laser components, like those used in lithography, its value can reach $15 million.

Your value is not defined only by what you are made of, but by how well you shape your potential into something extraordinary.

[Chad Fisher DNP @ChadFisher]

This shit gave me goosebumps.

[Coach AJ 🎯 Mental Fitness @coachajkings]

Billy Donovan shares a lesson that changed how his players thought about winning.

At Florida, he had a manager track how long the ball was in each player's hands during a game.

He asked one of his starters: "How many minutes do you think you had the ball in your hands for the game?"

The player said 15 minutes when he had played 30.

The real numbers?
"A backcourt player, for the most part, is probably 92% of the game gonna be played without the ball in their hands. A frontcourt player - 95% of their minutes is gonna be played without the ball in their hands."

Think about that. You're playing without the ball almost the entire game.

"It's amazing to me how many players focus on points, points, points. That's what goes on ESPN. That's what gets the highlights."

"But if you're gonna strictly talk about winning and you're really driven and motivated by winning and competing and being a good teammate, you have to look at the fact is -- what am I doing with my 92, 93, 94, 95%?"

"Am I screening? Am I running the floor? Am I on the floor for loose basketballs? Am I rebounding? Am I taking a charge?"

"There's so many ways to impact the game with the amount of time you're on the floor when the ball's not in your hands."

This is what separates good players from winning players.
You control how you show up.
You control your attitude.
You control your effort.

Great teammates master what they do when no one's watching - and when the ball isn't in their hands.

Winning isn't about the glamour. It's about the 95%.
(🎥@Coaching_U )
(🎥@brendansuhr)

[James R. Pellegrini Jr., MD @jaypelly]

@DiscussingFilm Lol noone realized he called him “brandon” instead of “brendan”

[James R. Pellegrini Jr., MD @jaypelly]

@Alphafox78 @grok wat song is this

[Eyewitness News @ABC7NY]

'Art saved my life': Father on Long Island finds inspiration in drawing on daughter's lunch bags https://t.co/TKvPS2lJUt

[Mariam Naveed, MD, FACG @MN_GIMD]

Two common modes - #ERBE Endocut Q & Forced Coag

⭐️ Forced Coag is a high-voltage, pulsed waveform electrosurgical mode designed to rapidly desiccate tissue and coagulate blood vessels.

✅ for cutting through vascular tissue and achieving hemostasis during snare resection.

⭐️ Endo Cut Q is a pulse-modulated electrosurgical cutting mode that alternates short cutting bursts with periods of coagulation.

✅ Deliver a precise, controlled incision
✅Minimize bleeding and thermal injury
✅Optimize tissue separation for safe resections

⭐️ Each Endo Cut Q cycle has two phases:

✅ Cutting phase: A burst of continuous waveform (pure cut) vaporizes tissue.

✅Coagulation phase: A lower-power modulated waveform helps seal small vessels.

✅ This pulsed pattern gives you clean dissection with built-in hemostasis.

✅ The cutting phase (yellow pedal ) uses a pulsed current, while the coagulation phase (blue pedal) uses a continuous current to achieve hemostasis.

✅ For polyp cutting many of us use Endocut Q mode (Effect 2-3, Duration 1, Interval 3). 

✅Important Considerations:
- Tissue type and lesion characteristics: influence the optimal settings.
- Endoscopist experience & clinical context.

[Mariam Naveed, MD, FACG @MN_GIMD]

Incredible lecture today by #ERBE on #Electrosurgery

Critical topic for all of us to understand to be a safe endoscopist especially fellows!

⭐️ Electrosurgery requires a closed circuit ➡️ Generator → Active Electrode → Patient Tissue → Return Path (Pad or Internal) → Generator

⭐️ Monopolar vs Bipolar👇

⭐️ Need Grounding Pad for Monopolar (ex APC, hot snare)

- Pad must have good skin contact to avoid burns.
- Pad should never be placed over:
•Bony prominences
•Scar tissue
•Implanted metal or devices

⭐️ Cut -> Continuous sinusoidal waveform -> Rapid heating → vaporization (tissue effect)

⭐️ Coag -> Interrupted or modulated waveform - > Slower heating → protein denaturation (tissue effect)

⭐️ Blend -> Mix of cut & coag -> Cut with some hemostasis (tissue effect)

✅ Use the right mode for the right

#IntrotoGI #GITwitter

[James R. Pellegrini Jr., MD @jaypelly]

@Amer1can_Barbie @50cent

[James R. Pellegrini Jr., MD @jaypelly]

Excited to have matched in advanced endoscopy fellowship at NewYork-Presbyterian/Brooklyn Methodist Hospital! Thankful to God, my wife, my kids, and all who have helped me achieve this dream! Can’t wait to get started! @ASGEendoscopy @Cornell @gitwitter @drdrej97

[Douglas G. Adler MD, FASGE, FACG, AGAF @DouglasAdlerMD]

Beautiful view of working trough some of the last fibers in a VERY hyperplastic pylorus in a patient with profound gastroparesis undergoing GPOEM. #gitwitter #gastroparesis #surgery @asge @gie

Are you referring gastroparesis pts for GPOEM?

[Douglas G. Adler MD, FASGE, FACG, AGAF @DouglasAdlerMD]

Pt with complete dysphagia. Tumor ingrowth through the uncovered part of a partially covered esophageal stent. Distal uncovered part had hyperplasia. Treated with a new stent inside the tumor ingrown part to good effect. #gitwitter #esophagus #surgery #medx #medtwitter