2025-06-24T22:06:59Z https://njump.cloud.vinney.xyz robbiemed https://njump.cloud.vinney.xyz/npub1drkh2km4l9dgfcza8ceghjnq2rcut6jwe22kj4x3dhuzaxvmzjjscqdwxy https://encrypted-tbn2.gstatic.com/images?q=tbn:ANd9GcQmyhJbQzFYikpvmRGlXbQhTFxjvB1K-X2iXIXQnXCj-5oEiywB https://encrypted-tbn2.gstatic.com/images?q=tbn:ANd9GcQmyhJbQzFYikpvmRGlXbQhTFxjvB1K-X2iXIXQnXCj-5oEiywB https://njump.cloud.vinney.xyz/nevent1qqs84hjjjl8pguqp5722s0hs9jzy0fmcafd66m2zcc9458yhx5ljvegzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env2222xaxav Still happy to be an employee <br/>Absolutely sick of the paperwork though 2025-10-21T19:54:26Z https://njump.cloud.vinney.xyz/nevent1qqs9ntmcryma4dvtj5q9qmxxr27pjh87hwx3l5aam5j9qnvk573etmczyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222g9tqyw Be on time<br/>Be alert<br/>No excuses<br/>No regrets 2025-06-17T13:53:48Z https://njump.cloud.vinney.xyz/nevent1qqswvc6vzgyvqtrjq692h0fm6ce04hh9e39je0wfcn8c4tktyt9c4sgzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222pprrl5 Residency day 2<br/>Just orientation, and honeymoon period still , but it’s wonderful to be an employee again 2025-06-17T13:53:08Z https://njump.cloud.vinney.xyz/nevent1qqsy7kfl6n8sl9j9ml2ymxp55696p778x5zq98c6a3esgd2xzkdquuczyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222us9sv4 The #EHJ just published a study looking at over 40,000 U.S. adults and found that those who drank #coffee exclusively in the morning (0400-1159) had a 16% lower risk of all-cause mortality and a 31% lower risk of cardiovascular disease-specific mortality compared to non-coffee drinkers. <br/><br/>*All-Cause Mortality*<br/> • Lower in morning coffee drinkers vs. non-drinkers (HR 0.88, 95% CI 0.81–0.96).<br/> • Lowest with 2–3 morning cups/day (HR 0.71, 95% CI 0.60–0.86).<br/> • No difference in all-day drinkers vs. non-drinkers (HR 0.99, 95% CI 0.90–1.10).<br/><br/>*Cause-Specific Mortality*<br/> • Lower #CVD mortality in morning drinkers (HR 0.69, 95% CI 0.55–0.87); #cancer mortality similar (HR 0.97, 95% CI 0.75–1.25).<br/> • No difference in CVD/cancer mortality for all-day drinkers.<br/> • Effects similar for caffeinated/decaf.<br/><br/>It was suggested that as drinking coffee later in the day may disrupt circadian rhythms and melatonin production, potentially increasing inflammation and blood pressure, thereby muting coffee’s health benefits in all-day coffe drinkers. However, regular, controlled morning coffee consumption could just be a marker of health-conciousness or a lower-stress life, i.e., several significant confounding variables were not addressed in the study. The study was funded by the National Heart, Lung, and Blood Institute; National Institute of Diabetes and Digestive and Kidney Disease; and National Institute of Health. I did not check to see if any of the members of these organizations, or if the Thor’s themselves, own coffee farms, roasteries, or coffee making equipment businesses, or have stock in publicly traded coffee companies. <br/><br/>Wang X, Ma H, Sun Q, et al. Coffee drinking timing and mortality in US adults. Eur Heart J, 2025. doi: 10.1093/eurheartj/ehae871<br/> 2025-02-03T16:23:11Z https://njump.cloud.vinney.xyz/nevent1qqsgqgekys8z0h4nznfjjz2gfy2423zzquc8gtlx7uwhg6rfuaenccszyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222eydc5d Chainsaw running on bench, because adjusting carb<br/><br/>Running chainsaw vibrates bench, causes phone to begin to slip<br/><br/>Grabs phone which is near blade, ends up with 3cm macerated lac<br/><br/>#ed #chainsaw 2025-01-21T20:29:52Z https://njump.cloud.vinney.xyz/nevent1qqsy0sq4mhal2tcxh9mzzpapqfy0ld56y2gcuwajjvy0ed3warzcmmczyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env2228gk8t5 Urolithiasis Pearls<br/>- Presence or absence of hematuria alone cannot be used to diagnose or exclude nephrolithiasis<br/>- Most stones ≤5 mm (70–98%) will pass spontaneously. Stones &gt;5 mm have smaller chance (25–51%) of spontaneous passage &amp; are more likely to need urologic intervention. (J Urol. 2015;194:1009)<br/>- Send pts home w/ strainer, esp 1st-time stone formers for stone analysis<br/>- Cx: Obstructed infected kidney (urologic emergency requiring urgent decompression), renal insufficiency, failed expulsion<br/><br/>Excerpt From<br/>Pocket Notebook: Pocket Emergency Medicine, 4e<br/>Erica Ashley Morse, MD<br/>#em 2025-01-21T17:11:33Z https://njump.cloud.vinney.xyz/nevent1qqsv4mkg6cwf865y27h43ry9d9xcjz24euuznnv8c6kkeun7xw8jmjgzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222aa4a30 Prolonged #tourniquet use during #venipuncture can lead to significant alterations in the concentrations of various analytes due to hemoconcentration and the movement of analytes from surrounding tissues into the bloodstream. The literature indicates that even short-term venous stasis can cause clinically significant changes in several analytes.<br/><br/>**Duration and Impact:**<br/>- 1 minute: Statistically significant changes can be observed in albumin, calcium, and potassium.[1] The AHA recommends that a tourniquet should not be applied for more than 1 minute to avoid significant increases in triglyceride levels.[1][2]<br/><br/>- 3 minutes: significant increases in alanine aminotransferase, total cholesterol, glucose, and potassium. Hemoconcentration effects are more evident[1][3]<br/><br/>**So**<br/>- It’s recommended to keep tourniquet application to less than 1 minute.[2]<br/><br/>- Waiting for 5 minutes with the needle in situ after removing the tourniquet can help reduce hemostasis-induced variability.[4] But this is never going to happen.<br/><br/>Basically, tourniquet application should not exceed 1 minute if you want to minimize the risk of significant alterations in analyte concentrations.<br/><br/>**Rationalization**<br/>[1] Lippi G, Salvagno GL, Montagnana M, Brocco G, Guidi GC. Influence of Short-Term Venous Stasis on Clinical Chemistry Testing. Clinical Chemistry and Laboratory Medicine. 2005;43(8):869-75. doi:10.1515/CCLM.2005.146.<br/>[2] Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2011;123(20):2292-333. doi:10.1161/CIR.0b013e3182160726.<br/>[3] Cengiz M, Ulker P, Meiselman HJ, Baskurt OK. Influence of Tourniquet Application on Venous Blood Sampling for Serum Chemistry, Hematological Parameters, Leukocyte Activation and Erythrocyte Mechanical Properties. Clinical Chemistry and Laboratory Medicine. 2009;47(6):769-76. doi:10.1515/CCLM.2009.157.<br/>[4] Devi S, Pasanna RM, Nadiger N, et al. Variability of Human Fasted Venous Plasma Metabolomic Profiles With Tourniquet Induced Hemostasis. Scientific Reports. 2021;11(1):24458. doi:10.1038/s41598-021-03665-2. 2025-01-21T16:52:20Z https://njump.cloud.vinney.xyz/nevent1qqstekvgm7uf2mpmatwkaefpg69ey6xnm8hs24jehmkgzmef46drzngzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222rp99km #olas #testflight link for iOS<br/><br/><a href="https://testflight.apple.com/join/2FMVX2yM">https://testflight.apple.com/join/2FMVX2yM</a> 2025-01-21T16:18:34Z https://njump.cloud.vinney.xyz/nevent1qqsyp79r7h8t4l7g9x4f2auh82pa8u3zc83l2qzdg924w8xad300rwqzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222jskufx So fun to zap from iPadOS 2025-01-21T12:46:08Z https://njump.cloud.vinney.xyz/nevent1qqst5fkz9d8fryegs47tr5fcld2djfj2mehdm45jpq7vqa4f958fd6qzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222l4nht9 The Vermont Health Information Exchange keeps health records in one place. Most Vermonters have a health record created for them, without their consent, in the Vermont Health Information Exchange. Doctors and other health care providers can view information about patient in their care for whom the Vermont Health Information Exchange has created a record. This centralized health record is intended to put providers on the same page.<br/><br/>vitl.net<br/><br/>A patient’s record in the Vermont Health Information Exchange may contain (but is not limited to): <br/>- Patient demographics – name, age, sex, date of birth, address, home phone, etc. <br/>- Problems and conditions <br/>- Allergies <br/>- Medications <br/>- Laboratory test results <br/>- Radiology reports <br/>- Transcribed reports <br/>- Patient care summaries <br/><br/>There are several ways to **opt-out** of having your information viewable to your providers in the Vermont Health Information Exchange: <br/><br/>- Call the Vermont Health Information Exchange Hotline at 888-980-1243 <br/>- Fill out an opt out form online <br/>- Download, print, complete this opt out form, and mail it to VITL, Attention: VHIE Support, 150 Dorset St., Suite 245, PMB 358, So. Burlington, VT 05403 2025-01-20T15:34:29Z https://njump.cloud.vinney.xyz/nevent1qqs9sae2ws78gdcrmnnleh4rjcx0asm95ndpcwsze62z50s7rythzqgzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222dmtgle In reply to <a href='/nevent1qqsywcux8k8xw6fvek2zy08gt8wzc6px4kmhjag9sf09tltzsmzkrkgqaxqwa'>nevent1q…xqwa</a><br/>_________________________<br/><br/>- Natural Medicine Comprehensive Database <br/>naturalmedicines.therapeuticresearch.com <br/><br/>- LactMed<br/>ncbi.nlm.nih.gov/books/NBK501922 2025-01-20T13:35:31Z https://njump.cloud.vinney.xyz/nevent1qqsvvwgqjgy00ux2m8gmv06jxndf5r6ccwwq6m0aukmgt3q4vfdwenszyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222rjnvdc In reply to <a href='/nevent1qqs28f57e68nq98n4meez9t2gpj7nkl3lrvexqm5mgrh34vf6tzuauqqk549j'>nevent1q…549j</a><br/>_________________________<br/><br/>Phenformin doesn’t matter 2025-01-19T21:07:58Z https://njump.cloud.vinney.xyz/nevent1qqs28f57e68nq98n4meez9t2gpj7nkl3lrvexqm5mgrh34vf6tzuauqzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222pfk6nu Better alternative to MUDPILES for high anion-gap metabolic acidoses: <br/>Iron/Isoniazid<br/>D - <br/>K - DKA <br/>A-<br/>Methanol <br/>Ethylene glycol <br/>Aspirin <br/>Lactic acidosis <br/><br/>What causes high anion gap metabolic acidosis?<br/>IDK, a meal? 2025-01-19T21:06:57Z https://njump.cloud.vinney.xyz/nevent1qqszjjhan7fp2sl0uq50z785z9p40vvmstpmpwcur688q5r7f5dtk0qzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222fzgx54 In reply to <a href='/nevent1qqsz68ekhaxcw09fguzp7xalv59s4lxg4m72nyn9qvdzzqcgk8u8xzcaz6ghz'>nevent1q…6ghz</a><br/>_________________________<br/><br/>Thanks 🤜🤛 2025-01-01T16:27:23Z https://njump.cloud.vinney.xyz/nevent1qqs22eg6t9mtw6y40x4zdduwk09kqwu5e2zurexth36p0a028sj8uwgzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222rhn6v2 In reply to <a href='/nevent1qqsvkseqwe7wp4qhxj4z77k89847vugaz0gytvfgwvl9eqlcg97avtqzcz32j'>nevent1q…z32j</a><br/>_________________________<br/><br/>Love the “always a student” attitude but I don’t have the MD part yet 😐 afaict no other M1234 students on here 🤔 2024-12-30T18:22:46Z https://njump.cloud.vinney.xyz/nevent1qqsyapkvytyrakn77zlp4fvk0fk7wyfkedde95kykyf4pca2p2vgw6gzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222663j4v Am I the only #medstudent on #nostr? Where is everyone? 2024-12-18T11:39:51Z https://njump.cloud.vinney.xyz/nevent1qqs8qywqjtpn2jzgue0xhefxxql8dy02tmx4u708pvhrxswqn205d7gzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env2227703dc Last #virtual interview for #residency! It’s been a ride! 2024-12-18T11:39:18Z https://njump.cloud.vinney.xyz/nevent1qqsqy77e7gvjtjvymuw69dfuwklllx0uul6gm49vy27v0w28cpmstuqzyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222tum84h Wrote an estimation tool to calculate the amount of sodium your patients are getting in their antibiotics, inspired by Frisbee at al.&#39;s 2019 article. <br/><a href="https://nabxcalc.vercel.app/">https://nabxcalc.vercel.app/</a><br/> #asknostr #hospitalist #AHRF #medicine 2024-04-26T13:04:34Z https://njump.cloud.vinney.xyz/nevent1qqszse6x86aujx6sxnlug82jqzc27xje7g7sgkngqzzvf4cwlhtzx2szyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222pn7uah In reply to <a href='/nevent1qqst3wae9y3qfnp6sat9wlf678a6rez09x9yjx4k8j36annctrnzqyc0nu6wj'>nevent1q…u6wj</a><br/>_________________________<br/><br/>Feedback is welcome!<br/>#medical #internalmed #antibiotics #calculator #asknostr 2024-04-25T21:54:59Z https://njump.cloud.vinney.xyz/nevent1qqst3wae9y3qfnp6sat9wlf678a6rez09x9yjx4k8j36annctrnzqyczyp5w6a2mwhu44p8qt5lr9z72vpg0r302fm9f262569klst5env222627gvs I wrote an estimation tool to calculate the amount of sodium your patients are getting in their antibiotics, inspired by Frisbee at al.&#39;s 2019 article. <br/><a href="https://nabxcalc.vercel.app/">https://nabxcalc.vercel.app/</a> 2024-04-25T21:54:12Z