Kevin Venus
@venuskev
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General Internist @uhn | Lecturer @UofT_DoM| #meded #diagnosticreasoning #periop #narrativemedicine | Striving to be non-inferior to placebo
Toronto, ON
Joined June 2010
Diagnosis is difficult- and rare disease diagnosis is inherently more challenging. How can we do better than simply having a "high index of suspicion"?
Ever consider what needs to go right to dx a rare condition in a busy modern clinic? In this @JournalGIM paper @venuskev, @KwanJanice and I present strategies for individuals, clinics, and systems to become better diagnosticians and where future may lead https://t.co/U1OMRsaEpv
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Shorter durations of #antibiotic prophylaxis, including no prophylaxis, appear noninferior to longer durations for preventing mortality in patients with #cirrhosis and upper gastrointestinal bleeding. https://t.co/mjtAuyryYf
@bradspellberg @DrToddLee
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New Primary Aldosteronism Guidelines - simpler, streamlined, and hopefully more pragmatic. https://t.co/eMfP6fO1mF
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Really important study- getting closer to answering the questions surrounding atrial fibrillation identified during hospitalization.
We are glad to share our latest manuscript in the @AnnalsofIM on stroke risk in patients newly dx w/ #afib while hospitalized for other causes. This work was funded by the @SCC_CCS #atrialfibrillation research award and was supervised by @denniskomd
https://t.co/yvrvgOMg2g
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Good summary of current state in periop neurocognitive dysfunction prevention... Best anaesthetic technique for prevention of postoperative cognitive dysfunction in older patients after hip fracture surgery – is the debate over?
associationofanaesthetists-publications.onlinelibrary.wiley.com
Click on the article title to read more.
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Study incl 2/3 intracranial procedures had 11% covert stroke rate assoc w incr postop delirium & long-term cognitive dysfunction. Rate in non-neurosurg pts only 3% (less than NeuroVISION)
pubmed.ncbi.nlm.nih.gov
Among patients aged 60 yr and older who had major noncardiac surgery, mainly intracranial, one in nine patients experienced a perioperative covert stroke. Covert strokes more than doubled the risk of...
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Despite lack of RCTs, use of rhythm control and anticoag for POAF have increased over time. Awaiting results from ASPIRE-AF re:anticoag. Temporal Trends in the Management Practices of Clinically Important Perioperative Atrial Fibrillation After Noncard…
pubmed.ncbi.nlm.nih.gov
Despite the absence of randomized controlled trials, the level of use of rhythm-control and anticoagulation treatment for POAF is rising. High-quality trials are needed urgently to determine whether...
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Fantastic thread highlighting the recent ACC/AHA Perioperative guideline update.
It was an incredible experience to be on the writing committee for the 2024 ACC/AHA Perioperative Guidelines, released earlier in September 2024. https://t.co/XKzbghVbTR Here is a thread featuring major takeaways from the new Perioperative guidelines. (from perspective of a
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1/9 Tweetorial - Part 1 2024 ACC Periop Guidelines: What's New/Different? Algorithm: in general (specifics to follow) -added risk modifiers (see below) -incorporated DASI & biomarkers Please comment, follow me, and repost. #CardioTwitter/#CardioX #HospitalMedicine
#spaqi #acp
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Continuation vs Discontinuation of RASIs Before Major Noncardiac Surgery
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It's heeerrree... ACC/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2024 Appropriate Use Criteria for Multimodality Imaging in Cardiovascular Evaluation of Patients Undergoing Nonemergent, Noncardiac Surgery | Journal of the American College of Cardiology
jacc.org
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POAF was significantly associated with a higher risk of postop ischemic stroke w/i 1 yr & was mitigated by postop anticoag. A model could assist in identifying high-risk pts before NCS. Role of anticoag in modifying stroke risk assoc with new-onset POAF https://t.co/NHlnjXOF9w
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Some good news for preop consults: Major vascular surgery patients assessed by a cardiology or GIM physician prior to surgery have better outcomes than those who are not.
pubmed.ncbi.nlm.nih.gov
Major vascular surgery patients assessed by a cardiology or GIM physician before surgery have better outcomes than those who are not. Further research is needed to better understand potential...
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A lot of good advice in this thread- especially re: transfer timing and decisions. I often debrief with trainees when ward resuscitations have been challenging or inefficient- it’s very difficult to care for critically ill patients outside of a critical care environment.
It is hard resuscitating patients on the ward 🏥 You don't have the same resources, personnel, or familiarity with the physical space. This can lead to slow and clunky resuscitations. 🦥 Here are 10 tips for smooth resuscitations on the ward that I learned as a paramedic (and
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Efficacy and Safety of Apixaban according to the CHADS2-VASc score in AHREs - ARTESiA subanalysis by Jeffrey Healey Absolute risk reduction for stroke and systemic embolism only in pts with CHADS2-VASc >4 Manuscript 👉 https://t.co/HaaktjnDYW
#HRS2024 @HRSonline
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Is SGLT2i-DKA mediated by genetic factors? Not sure, but thank you to all of our study sites for recruiting patients. We are approaching 70% recruitment. After that we will do some fancy GWAS!! Text/call/sos/ring my doorbell if you want to learn more! @fs36r
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1/n Hyponatremia in cirrhosis rounds: case 1: ESLD 2/2 ETOH. Admitted at OUH 2/2 abd distension/lethargy w/sNa 133. Kept on spirono + furosem + lactulose. Gradual ⬇️in sNa in 10 days. Transferred 4 ⬆️level of care. Arrives with sNa 125, sCr 0.8. Alert, jaundice, ascites, no edema
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Now we’re talking - and this editorial is from an anesthesiologist - not a hospitalist. Couldn’t agree more. Pre-operative withdrawal of renin–angiotensin inhibitors: time to re-visit current guidelines | European Heart Journal | Oxford Academic
academic.oup.com
This editorial refers to ‘Discontinuation vs. continuation of renin–angiotensin system inhibition before non-cardiac surgery: the SPACE trial’, by G.L. Ack
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1/10 ORAL IRON IN IRON DEFICIENCY ANEMIA (IDA) I tweeted a poll asking how you would treat a case of uncomplicated IDA with oral iron. The options and responses are shown below:
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#cancer patients+ AF🫀on #DOACs often need invasive procedures. #PeriOp DOAC management in PAUSE study ▶️ @JRand083 et al find active cancer=📈surgical bleeding🩸 Cautious 💊is crucial‼️ #CardioOnc #thrombosis #hemostasis @OttawaHospital @McMasterU @isth
https://t.co/f4D0k5NKM4
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