Tobi Olusakin

Un médico.

[Tobi Olusakin @tobicaleb]

@_Lummyde Yeah

[Tobi Olusakin @tobicaleb]

"Pulp Fiction"

[Know Me @KnowMe_03]

This is one of the best and underrated scenes of all time.😭

[IMAX @IMAX]

VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE VILAH HARU DE ELISVE TU ELISVE ELISVE ELISVE

[Benito @Baswa_]

On peut reparler de la musique de Hans Zimmer dans DUNE 2 ??

Je frissonne à chaque fois.

[Shadow Knight @shadowknightdk]

making these is kinda fun

[Tobi Olusakin @tobicaleb]

🤣🤣🤣

[Uraharastudio @Uraharastudio]

This would be peak ending in the World Cup

[ٰ @dazedlewis]

it’s that time again

[DUNE @dunemovie]

“Forgive me for all I’ve done.” Experience the epic conclusion. Dune: Part Three only in theaters and IMAX December 18. #DuneMovie #FilmedforIMAX

[Dr. Chacón-Lozsán F .'. @franciscojlk]

💊 “7 days of antibiotics” for community acquired pneumonia may soon become another example of medical inertia.

The study evaluated hospitalized non ICU CAP patients who:
✅ received 3 days of antibiotics
✅ became clinically stable by day 3
✅ had no severe immunosuppression or major complications

Patients receiving:
• short therapy (3 to 4 days total)
were compared against
• longer therapy (≥5 days)

Key finding:

⚠️ Outcomes were remarkably similar.

Short course therapy showed no major difference in:
• mortality
• readmission
• urgent care visits
• C. difficile infection

The adjusted mortality RR was: 0.89 (95% CI 0.01–2.25)

Importantly, mortality was extremely low in BOTH groups.

But perhaps the most interesting finding was not about antibiotics.

It was about patient selection.

📊 Out of 55,517 hospitalized CAP patients, ONLY 10.1% fulfilled strict eligibility criteria for ultra short treatment.

This highlights a critical real world problem in antimicrobial stewardship:

Evidence often applies to a far narrower population than we assume.

The majority of CAP inpatients were excluded because of:
• COPD or structural lung disease
• immunosuppression
• organ dysfunction
• anti Pseudomonas/MRSA therapy
• instability by day 3

So while shorter therapy appears safe in carefully selected stable patients, the evidence gap remains enormous for:
⚠️ frail elderly
⚠️ immunocompromised patients
⚠️ severe CAP
⚠️ persistent hypoxemia
⚠️ ICU populations

📉 Antibiotic duration should be physiology guided, not calendar guided.

Clinical stability mattered more than arbitrary duration:
• afebrile
• stable BP
• no tachycardia
• stable oxygen requirement
• normal mentation

This is probably the future of inpatient infectious disease management: individualized, physiology driven therapy duration.

Not: “complete 7-10 days because that’s what we always do.”

Another very strong methodological point:

🧪 The study used target trial emulation methodology.

This increasingly important epidemiological framework attempts to reproduce the rigor of randomized trials using large observational datasets while minimizing immortal time bias and confounding.

We will likely see this methodology used more frequently in:
• antimicrobial stewardship
• ICU medicine
• perioperative medicine
• real world effectiveness research

My main takeaway:

⚠️ We probably overtreat many stable CAP patients.

But We still lack sufficient evidence for the complex, fragile, comorbid patients we see daily in real world internal medicine and ICU practice.

That distinction matters enormously.

📖 Doumat G, Ratz D, Horowitz JK, et al. Short Versus Longer Antibiotic Duration for Community Acquired Pneumonia: A Multicenter Target Trial Emulation. Annals of Internal Medicine. 2026.

[Nick Mark MD @nickmmark]

One of my favorite aviation phrases:
“Superior pilots use their superior judgement to avoid having to demonstrate their superior skills.”

It’s true for any proceduralist btw.

[David Juurlink @DavidJuurlink]

To generate a case report of acute dystonia complicating serotonin syndrome

[Kelly Haughton, MD @kidneydoctorpa]

AKI guidelines hadn’t been updated since 2012.
The KDIGO 2026 AKI/AKD Public Review Draft just dropped and it changes how we define, diagnose, and follow up after acute kidney injury.
Here’s what every nephrologist, intensivist, and internist needs to know 🧵
⚠️ Public review draft only · Not yet final guidelines

[naija prince 🇳🇬 @NiyiMk]

new dyslipidemia guidelines just dropped per ACC

[Neil Renic @NC_Renic]

The journal: “your work is being cited”

Me: 😃

The citation: “…as he stupidly and unattractively argues…”

[JAMA @JAMA_current]

Point-of-care ultrasonography (#POCUS) is a noninvasive bedside imaging modality used to assess intravascular volume status in hospitalized or emergency department patients with possible #VolumeOverload.

POCUS evaluates the inferior vena cava, internal jugular vein, and lung parenchyma with high-frequency linear, low-frequency phased-array, and low-frequency curvilinear probes.

[Joel M. Topf, MD FACP @kidney_boy]

The Hyponatremia Intervention Trial finally was published this week in NEJM Evidence. This is the first large scale, multi-center, randomized, controlled trial on hyponatremia since Shrier published SALT 1 and 2 in 2006. I described the trial and my initial thoughts on it in a post today
on Roon.

[Dr Aditya Gudheniya @Gastronaut___]

Albumin is no longer part of the diagnostic criteria for HRS-AKI.

The ADQI–ICA 2024 consensus removes the mandatory 48-hour albumin challenge.

Albumin is now a therapeutic tool, not a diagnostic requirement.

Volume assessment should be individualized:
• Hypovolemia → crystalloid or albumin
• Euvolemia/overload → do not delay vasoconstrictors.

[Tobi Olusakin @tobicaleb]

What a year!