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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 1h

(Random question:
Would you mind following me on blue sky and/or Twitter/X?
I wanted to DM you but we don’t follow each other so I cannot.
I have “Professio-personal academic and practical/clinical career with Internet-related outreach” questions.)

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 1h

And an even better one in those at risk for ampC B-lactamase producing infections ;-)

The fact that @sccmcriticalcare.bsky.social and @accpchest.bsky.social die on this hill of ACORNs against cefepime is bananas to me.
@idsainfo.bsky.social has got my back though.
@absteward.bsky.social you down?

James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 1h

The argument could be made that patients initially admitted had community acquired AKI which resolves w/in 48h of admit ~60% w/ support. Then, non-V-HAP doesn’t necessarily include AKI. & I would argue most CKD= 3a not >/=3b. So, we good.

I looked into it. ;-)
www.contagionlive.com/view/nonvent...

Nonventilator Hospital-Acquired Pneumonia: Epidemiology, Prevention, and Where It Is Now | Contagion Live

The management of hospital-acquired pneumonia requires use of preventive bundles, mitigative of risk factors, and prompt diagnosis with initiation of treatment when highly suspected.

www.contagionlive.com

James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 3h

#hottake

#Cefepime is safe & ACORN trial is overblown. Avoid in elderly+AKI.

#idsky #medsky #pulmsky #IDcrit #criticalcare @pulmcrit.bsky.social @bradspellberg.bsky.social @mbrigmon.bsky.social @idvilchez.bsky.social @erinmccreary.bsky.social @abxstewardess.bsky.social @pharmageddon.bsky.social

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 1d

First part to that study series:

pubmed.ncbi.nlm.nih.gov/33591002/

The Association Between Antibiotic Delay Intervals and Hospital Mortality Among Patients Treated in the Emergency Department for Suspected Sepsis - PubMed

Both recognition delays and administration delays were associated with increased hospital mortality, but only for longer delays. These results suggest that both metrics may be important to measure and...

pubmed.ncbi.nlm.nih.gov

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 1d

Studies out of Atrium health in North Carolina showed that it didn’t matter if you gave the Gram positive or Gram negative coverage first.

I don’t have a Dr Kumar’s contact here, but even he agreed in his abx-timing series that began in 2006 through 2010s.

pubmed.ncbi.nlm.nih.gov/33706252/

First-to-second antibiotic delay and hospital mortality among emergency department patients with suspected sepsis - PubMed

First-to-second antibiotic delay of greater than one hour was associated with an increased risk of hospital death among patients meeting criteria for septic shock but not all patients with suspected s...

pubmed.ncbi.nlm.nih.gov

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 1d

#hottake

Early identification and supportive management is more important than early #Antibiotics in #Sepsis #SepticShock

#idsky #medsky #pulmsky #IDcrit #criticalcare @pulmcrit.bsky.social @bradspellberg.bsky.social @mbrigmon.bsky.social @vipsmdmed.bsky.social @idvilchez.bsky.social

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 2d

I can’t imagine this is what people actually voted for. This is a travesty. We used to be the world leading experts and medical science.

What have we done…?

#medsky #idsky #rfkjr #rfkjrisdangerous #trumpisanationaldisgrace

Carolyn Barber, MD @cbarbermd.bsky.social · 2d

The CDC is over. It was killed.” — Dr. Demetre Daskalakis, who resigned in protest.

RFK Jr. & Trump have shattered America’s disease defense:
❌ Fired outbreak trackers & vaccine scientists
❌ Abolished the National Center for Immuniz & Respiratory #BlueSky #MedSky #NewsSky #SciSky 🧪 #NurseSky

"CDC is over": RFK Jr. lays off over 1,000 employees in Friday night massacre

Amid the ongoing shutdown, the HHS secretary wiped out entire offices that investigate disease outbreaks, manage infectious disease responses and collect data.

www.msnbc.com

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Reposted by James Wilson, DO, FACP, FAWM, CTropMed

Alice (SHE/HER) Sato, MD PhD @asato4kids.bsky.social · 2d

Join @defendpublichealth.bsky.social in showing that RFK Jr is NOT supported by physicians and scientists

bsky.app/profile/evil...

50501: The People’s Movement ❌👑 @50501movement.bsky.social · 2d

“CDC is over. It was killed. This administration only knows how to break things. They have made America at risk for outbreaks and attacks by nefarious players. People should be scared,” said Dr. Demetre Daskalakis, former director of the CDC’s National Center on Immunization and Respiratory Diseases

"CDC is over": RFK Jr. lays off over 1,000 employees in Friday night massacre

Amid the ongoing shutdown, the HHS secretary wiped out entire offices that investigate disease outbreaks, manage infectious disease responses and collect data.

www.msnbc.com

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Reposted by James Wilson, DO, FACP, FAWM, CTropMed

UW Infectious Disease Fellowship Program @uwidfellowship.bsky.social · 2d

From the Lancet today, the Global Burden of Disease… #IDSky

“During the COVID-19 pandemic, disability-adjusted life-years (DALYs) due to infectious, maternal, neonatal, and nutritional diseases all increased, but have since returned to pre-pandemic levels. “

www.thelancet.com/journals/lan...

Health progress in a post-COVID-19 world

The COVID-19 pandemic upended global mortality and morbidity. COVID-19 was ranked as the number one age-standardised cause of death globally in 2021 but by 2023 had dropped to the 20th cause of death ...

www.thelancet.com

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Reposted by James Wilson, DO, FACP, FAWM, CTropMed

UW Infectious Disease Fellowship Program @uwidfellowship.bsky.social · 2d

In today’s Global Burden of Disease overview in the Lancet, “remarkable” health gains in communicable diseases.

Public Health/ID research, outreach, prevention and treatment save lives. #IDSky

UW Infectious Disease Fellowship Program @uwidfellowship.bsky.social · 2d

“Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837–917) in 2010 to 681 million (642–736) in 2023” #IDSky

www.thelancet.com/journals/lan...

Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990–2023: a system...

Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural ri...

www.thelancet.com

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Reposted by James Wilson, DO, FACP, FAWM, CTropMed

UW Infectious Disease Fellowship Program @uwidfellowship.bsky.social · 2d

On a positive note, declines in communicable diseases including diarrheal illness, TB and measles have contributed to decreases in overall mortality.

Hat tip to the public health programs that fostered this progress #IDSky

UW Infectious Disease Fellowship Program @uwidfellowship.bsky.social · 2d

“Four other leading causes [of death] have also shown large declines in global age-standardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. “ #IDSky

www.thelancet.com/journals/lan...

Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

We examined global mortality patterns over the past three decades, highlighting—with enhanced estimation methods—the impacts of major events such as the COVID-19 pandemic, in addition to broader trend...

www.thelancet.com

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 2d

Hot take:

You WANT the #creatinine to go up while diuresing in #cardiorenal syndrome AKI.

It’ll come back down when they’re better.

It’s a feature, not a bug.

#Medsky #Nephsky #cardiosky #cardiology #criticalcare @pulmcrit.bsky.social @imcrit.bsky.social #AKI #heartfailure #diuresis

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 2d

@pulmcrit.bsky.social
Are you coming to Chicago..?
I have things for you to sign…
THINGS…

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Reposted by James Wilson, DO, FACP, FAWM, CTropMed

TRAstonDrs @castltrastondrs.bsky.social · 10d

#Medsky🧪 #IDsky #immunosky #oncosky #publichealth While not a classic #oncogenicvirus, #SARSCoV2 might fuel #lungcancer through multiple indirect mechanisms, creating a pro-tumorigenic environment in t🫁 .

Dr David Joffe MB BS(Hons), PhD, FRACP @davidjoffe64.bsky.social · 11d

The double-edged sword: How SARS-CoV-2 might fuel lung cancer:
Investigating the potential oncogenic mechanisms of the novel coronavirus
in lung carcinogenesis

doi.org/10.1016/j.ma...

Redirecting

doi.org

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 10d

Vibrio, Toxo, HAV, Norovirus.
Anything that can contaminate water ways and then build up in bivalves and reproduce can cause outbreaks… mussels and oysters… they just drink up the salt water nutrients, poop and all ;)

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Reposted by James Wilson, DO, FACP, FAWM, CTropMed

Pharmageddon @pharmageddon.bsky.social · 10d

Next draft Infection Card for Epipocalypse: Bug Detectives: Nocardia!

One of my favs. Doesn't get enough love. The other group of organisms causing chronic CNS + pulmonary syndromes besides TB and fungi.

#IDSky #MedSky #EpiSky any feedback or suggestions?

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Reposted by James Wilson, DO, FACP, FAWM, CTropMed

Contagion® @contagionlive.bsky.social · 13d

The Centers for Disease Control and Prevention (CDC) provided more information on a multistate outbreak and genomic testing. #IDsky #Medsky

Listeria Outbreak Update: 3 More Illnesses and 1 Death Linked to Packaged Meals

The Centers for Disease Control and Prevention (CDC) provided more information on a multistate outbreak and genomic testing.

www.contagionlive.com

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 13d

@accpchest.bsky.social this is going to be addressed soon, right? I mean, it’s October now..?
#accp #chest #abimexams #boardprep

James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · Sep 3

www.instagram.com/reel/DOJdAFk...
God…. Thank you for @glaucomflecken.bsky.social
Every IM & ICU rounds with nephrology and every time someone ordered urine chemistries and serum osmolalities…
Did it change your clinical management…? Did it? DID IT, ABIM EXAM?
#nephrosky #criticalcare #medsky

Login • Instagram

Welcome back to Instagram. Sign in to check out what your friends, family & interests have been capturing & sharing around the world.

www.instagram.com

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · Sep 3

#ACIP is taking public comments..!

Get yours in TODAY!

#idsky #medsky

www.regulations.gov/docket/CDC-2...

@idvilchez.bsky.social @bradspellberg.bsky.social @wwrighid.bsky.social @paulsaxmd.bsky.social @astmh.bsky.social @alt-hhs.altgov.info @idsainfo.bsky.social @idstewardship.bsky.social

Regulations.gov

www.regulations.gov

James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · Sep 3

I appreciate IV APAP, but unfortunately it also leads to mutations…
But yea, stuff WORKS for pain and fevers! “Surgeons only,” such BS

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · Aug 28

Couldn’t agree more!
Don’t know how I could tell people to sit at home febrile but unable to mitigate their fevers, etc.

James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · Aug 28

Love it
Real world application is..?

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James Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · Aug 26

Is the new @natmicrobiol.nature.com study about Cipro and NSAIDs and APAP, is this practice changing for you?
Reply:
1 yes!
2 …ehhhhh…
3 need in vivo data
4 what study..?
#idsky #medsky

Joseph Marcus @josephmarcusid.medsky.social · Aug 26

Combining ibuprofen or acetaminophen with ciprofloxacin in vitro greatly increases mutagenesis for genes leading to cipro-resistance.

(Not the case for diclofenac, furosemide, metformin, atorvastatin, tramadol, temazepam, and pseudoephedrine)

#IDSky

www.nature.com/articles/s44...

The effect of commonly used non-antibiotic medications on antimicrobial resistance development in Escherichia coli - npj Antimicrobials and Resistance

npj Antimicrobials and Resistance - The effect of commonly used non-antibiotic medications on antimicrobial resistance development in Escherichia coli

www.nature.com

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