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#IDTwitter #IDFellows
Introducing our new series: “IDFN top 10 articles every fellow should read”🔖

#1: SAB management
by @mmcclean1 @LeMiguelChavez
Reviewers @KaBourgi, @IgeGeorgeMD, @Courtcita, @MDdreamchaser

We know is subjective & expect feedback/future improvements 👇

 1. Clinical management of Staphylococcus aureus bacteremia: a review.
https://t.co/9tBCtp9mlP
👉 A must read written by Holland et al. where they review the evidence of the management of SAB.
2. Impact of Infectious Disease Consultation on Quality of Care, Mortality, and Length of Stay in Staphylococcus aureus Bacteremia: Results From a Large Multicenter Cohort Study.
https://t.co/XujO68pCuH
👉ID consult associated with reduced inpatient mortality.
3. Predicting Risk of Endocarditis Using a Clinical Tool (PREDICT): Scoring System to Guide Use of Echocardiography in the Management of Staphylococcus aureus Bacteremia
https://t.co/otcA1pxjAw
👉Predictive risk factors for infective endocarditis, and thus the need for TEE.
4. The Cefazolin Inoculum Effect Is Associated With Increased Mortality in Methicillin-Susceptible Staphylococcus aureus Bacteremia.
https://t.co/CQZiryVWZz
👉Presence of cefazolin inoculum effect in the infecting isolate was associated with an increase 30-day mortality.
5. Cefazolin versus anti-staphylococcal penicillins for treatment of methicillin-susceptible Staphylococcus aureus bacteraemia: a narrative review.
https://t.co/mwaQ6Aw5vX
👉Similar outcomes for treatment of MSSA but more side effects with the anti-staphylococcal penicillins.
6. Use of vancomycin or first-generation cephalosporins for the treatment of hemodialysis-dependent patients with methicillin-susceptible Staphylococcus aureus bacteremia.
https://t.co/Z7qxeZD8DM
👉Vancomycin had higher risk of treatment failure compared to cefazolin in MSSA BSI.
7. Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus.
https://t.co/9W1sYv3VR0
👉RCT: dapto noninferior to SOC (B-lactams or vanco + gentamicin). Dapto resistance can emerge on treatment and more renal dysfunction in the SOC arm.
8. Adjunctive rifampicin for Staphylococcus aureus bacteremia (ARREST): a multicenter, randomized, double-blind, placebo-controlled trial.
https://t.co/SWsKR78njJ
👉 Rifampin addition not different to standard therapy in failure, recurrence or death.
9. Effect of Vancomycin or Daptomycin With vs Without an Antistaphylococcal β-Lactam on Mortality, Bacteremia, Relapse, or Treatment Failure in Patients With MRSA Bacteremia: A Randomized Clinical Trial. (CAMERA-2)
https://t.co/hNzJM4AOv5
👉more AKI with combination w/o benefit.
10. A Narrative Review of Early Oral Stepdown Therapy for the Treatment of Uncomplicated Staphylococcus aureus Bacteremia: Yay or Nay?
https://t.co/2ysr7lDYBW
👉 Oral step-down therapy can be an alternative in some select patients without complicated SAB.
Which article did we miss, or you would include in this list?
@BCMIDFellowship @DartmouthID @OhioState_ID @BIDMC_IDFellows @Tufs_ID @IUIDfellowship @UAB_ID @yaleIDfellows @ID_musc
@templeID1 @VUMC_IC @MayoclinicINFD @MGH_ID @UCLA_ID @MontefioreID @UNMC_ID @UVA_ID @OhioState_ID @UTSWinfDis @BrownIDprogram @RushCCH_ID @OHSU_ID
Also, check out this timeline of landmark trials.
Which trial would you like to add?
Next in "IDFN top 10 articles every fellow should read”:

- Infective Endocarditis 💙🦠

Coming soon: Osteoarticular infx , Enterobacterales infx, Transplant ID and more.

Check out the next tweet if you want to be an author of this series.
The IDFN is looking for content creators! Please retweet and share!

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In years past that desire was often very alive.

These days, I'm rarely directly or viscerally in contact with it.

I sometimes contemplate aiming for some other kind of romantic and/or sexual relationship instead. In part because I might be more effective if I...I don't know, got laid more? But that's not really the thing. More like, if I had someone around whom I could regularly relax.

But mostly, I don't pursue those alternative relationship-setups out of a sense of something like loyalty to myself + a vague sense of wrongness and/or sadness about it. It often feels like giving up or giving in.

[I might elaborate on the wrongness sometime.]
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Smoking gun.


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@LaurenThoman
I should mention, this is why I keep talking about this. Because I know so many people who legally CAN'T.

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This is a what I’d call a funny tale about how you never know how things are going to circle back:
(Long thread warning, but I think it's worth it)
1/?

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Truth be told, is usually the best choice for a child, just not in my case.
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A Thread on the Boss himself @Mitesh_Engr

Mitesh Sir's Positional Option Selling 101:

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• Exit criteria
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Done with the help of @niki_poojary


How @Mitesh_Engr Sir finds the direction?

• Daily charts S/R
• 75 min charts S/R
• Intraday trend
• Always play directional
• Never trades in strategies


Which options to sell in weekly expiry according to @Mitesh_Engr?

• Weekly candle High/Low
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Position Sizing by @Mitesh_Engr Sir.

How to deploy your capital?

• First sell 20%
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• When to exit
• What to do when view goes wrong
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Some important tweets of @Mitesh_Engr Sir

• What Data to look at
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KrishnaLeela
@Talesofkrishna
🌿𝑻𝒉𝒆 𝒔𝒕𝒐𝒓𝒚 𝒐𝒇 𝒂 𝑺𝒕𝒂𝒓 : 𝑫𝒉𝒓𝒖𝒗𝒂 & 𝑽𝒊𝒔𝒉𝒏𝒖

Once upon a time there was a Raja named Uttānapāda born of Svayambhuva Manu,1st man on earth.He had 2 beautiful wives - Suniti & Suruchi & two sons were born of them Dhruva & Uttama respectively.
#talesofkrishna https://t.co/E85MTPkF9W


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#KrishnaLeela


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One day when Dhruva was just 5 years old he went on to sit on his father's lap. Suruchi, the jealous queen, got enraged and shoved him away from Raja as she never wanted Raja to shower Dhruva with his fatherly affection.


Dhruva protested questioning his step mother "why can't i sit on my own father's lap?" A furious Suruchi berated him saying "only God can allow him that privilege. Go ask him"
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Vibhu Vashisth
Vibhu Vashisth
@VIBHU_Tweet
प्राचीन काल में गाधि नामक एक राजा थे।उनकी सत्यवती नाम की एक पुत्री थी।राजा गाधि ने अपनी पुत्री का विवाह महर्षि भृगु के पुत्र से करवा दिया।महर्षि भृगु इस विवाह से बहुत प्रसन्न हुए और उन्होने अपनी पुत्रवधु को आशीर्वाद देकर उसे कोई भी वर मांगने को कहा।


सत्यवती ने महर्षि भृगु से अपने तथा अपनी माता के लिए पुत्र का वरदान मांगा।ये जानकर महर्षि भृगु ने यज्ञ किया और तत्पश्चात सत्यवती और उसकी माता को अलग-अलग प्रकार के दो चरू (यज्ञ के लिए पकाया हुआ अन्न) दिए और कहा कि ऋतु स्नान के बाद तुम्हारी माता पुत्र की इच्छा लेकर पीपल का आलिंगन...

...करें और तुम भी पुत्र की इच्छा लेकर गूलर वृक्ष का आलिंगन करना। आलिंगन करने के बाद चरू का सेवन करना, इससे तुम दोनो को पुत्र प्राप्ति होगी।परंतु मां बेटी के चरू आपस में बदल जाते हैं और ये महर्षि भृगु अपनी दिव्य दृष्टि से देख लेते हैं।

भृगु ऋषि सत्यवती से कहते हैं,"पुत्री तुम्हारा और तुम्हारी माता ने एक दुसरे के चरू खा लिए हैं।इस कारण तुम्हारा पुत्र ब्राह्मण होते हुए भी क्षत्रिय सा आचरण करेगा और तुम्हारी माता का पुत्र क्षत्रिय होकर भी ब्राह्मण सा आचरण करेगा।"
इस पर सत्यवती ने भृगु ऋषि से बड़ी विनती की।


सत्यवती ने कहा,"मुझे आशीर्वाद दें कि मेरा पुत्र ब्राह्मण सा ही आचरण करे।"तब महर्षि ने उसे ये आशीर्वाद दे दिया कि उसका पुत्र ब्राह्मण सा ही आचरण करेगा किन्तु उसका पौत्र क्षत्रियों सा व्यवहार करेगा। सत्यवती का एक पुत्र हुआ जिसका नाम जम्दाग्नि था जो सप्त ऋषियों में से एक हैं।
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Jeet Heer
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1. Now that Stan Lee is being eulogized far and wide, it's important to remember how marginal Stan Lee and his collaborators (Jack Kirby and Steve Ditko) were in the 1950s and 1960s.

2. Marvel Comics (before that Atlas) was just a cog in the machine of a bottom pulp publisher run by Martin Goodman, the husband of one of Lee's cousins. It was the lowest of the low in the publishing world.

3. Now Mario Puzo (not yet the author of the Godfather) shared offices with Stan Lee in the 1950s and 1960s. Puzo wrote for garrish men's adventure magazines and, like Lee, dreamed of writing a novel & breaking out. But Puzo looked down on Lee.

4. Flo Steinberg, 1960s secretary at Marvel: "They were always making jokes about us. They'd come in and giggle. mario Puzo would look in and would see us all working on his way to the office and say, 'Work faster, little elves. Christmas is coming.'"

5. When JFK was killed, the whole office of Magazine Management was stunned and quiet. Except Lee. He continued working. "He was still working on the comic books," Puzo said. "Like that was the most important thing in the world."
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Julien \U0001f332
Julien 🌲
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1/ there is this sense when you are young that your accomplishments need to be a list of things that seem impressive to others. A list of several items you did.

This isn't actually right, so here is another suggestion.

2/ I remember being 26 and writing about reading 52 books a year. I wrote blog posts about it. They got copied. It became "a thing." Now it's in Twitter bios. It looks impressive but it's insanely useless and I shouldn't have done it.

3/ what I should have known at that time is that only young idiots like myself, with no accomplishments, find list of tiny achievements impressive. Anyone who has actually done anything of substance doesn't gaf

4/ what is actually difficult, and worthwhile, instead is to do ONE single thing for a very, very long time. It's much harder and much rarer and results in outlier outcomes much more often.

Of course you can find this out too late if you are chasing the dragon of Ted talks etc

5/ if I had only worked on a startup for a year, I would've gotten nowhere, the same way that if you lift for 3 months, it achieves nothing. Everything good in life comes from perseverance, but at the beginning, you're just like "I need to be somebody!!!"
LIFE