James Dundas @angularboxoid
Imaging Cardiologist. TTE, TOE, CMR, Cardiac CT. Astronomy, cinema, wine, beer, coffee, board games, politics, doomscrolling, Leicester Tigers, SAFC. Newcastle UK via Vancouver BC Joined August 2010-
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@RednalNut @BBCNews 10-20 years (more exactly, 17 from 2008-2025) of deliberate pay restraint as govt policy - choosing to offer no or subinflationary pay rises. You can do that for a bit and say “the country is broke”, and people will grudgingly accept it. Eventually at 20-30% behind, no longer.
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@Megsenmumdr @doctor_katie @Parody_RCGP @DrSteveTaylor Would treat it the same way as the few practices that do riders saying “this referral can’t be rejected / turned to A&G” - ie, ignore, do whatever I think is right for the patient.
On call done, first day of holidays - At the test!
@SamRo It’s the summer? Of course he can take time off?
@Blue_Froglet @Mecha_Jay @RealTimVine In what possible way have you been ‘persecuted’ by Starmer?
@baronfitzw @DrSiyabMD In which case - don’t do the test! The test result is the only new info. Everything else was known, and if you will rightly use that to decide no action, whether the test was positive or negative, don’t do that test. This is why screening or irrational testing fails so often.
@Eccothe2k Well sure, but reform intrinsically largely attracts poor candidates. Angry white men with dodgy social media histories and barely concealed bigotry is essentially the stock in trade. Perhaps they have better ones but if so they’re very well hidden.
@UtdMaI It’s more impressive right now. Clearly mbappe might do 2-3 more WCs and end on 30+ WC goals. Just wait and see?
@0x_rxkvys In many countries, we now have pipes that bring water directly to your house, without using a taxi at all. Hopefully one day San Francisco will get this technology.
James Dundas retweeted
WE'RE ALL GOING ON A EUROPEAN TOUR 🌍
James Dundas retweeted
The moment Sunderland players discovered they’d qualified for European football for the first time in over 50 years. Those fans will be able to create special memories next season, I’m so happy for them! 👏👏
@SimonFraser00 People say this every year, and they’re just wrong. The playoffs are great, and it stops there being a huge dead rubber fest at the end of the season where most of mid table have nothing to play for.
@AcademicTruther @cardiojaydoc02 @DavidLBrownMD Come on, what? Nobody would reasonably expect a mechanic to be back at work the day after being extubated. My grandad was a car mechanic and lost two finger tips in a work accident with a hydraulic jack. He obviously didn’t go back to work the next day…
@DavidLBrownMD Not saying things might not have swung too far; but it seems very glib and heartless to say “nobody in my residency committed suicide” when physician suicide is quite a well documented phenomenon. You’d be unimpressed if (when) colleagues decided to stent based on n=3 data…
@abhinuv23 @drjohnm Indeed, you can’t fight culture. I wonder if it’s a relic from US historically having low radial access rates? I can’t recall stopping OAC for angiography since the last days of femoral only operators (>10y ago).
@abhinuv23 @drjohnm Wasn't the question 'new' AF? Plenty of patients with established AF have NSTEMI. Quite often patients present with AF/rate-related symptoms and trop rise - not type 1 NSTEMI. less often, might have symptoms felt more likely to be ischaemic, but also new AF - may have both.
@abhinuv23 @drjohnm Of course can happen, but wouldnt have said very frequent that both events are brand new and independent. Usually can clinically adjudicate and do no coronary test (or CT). But when it does occur - why woudn't one just start a DOAC and send to cath?
@VerwerftJan @drbennisahmed @bwoody58 Impressive that you can resource this - I am not saying there are no centres in UK that offer iCPET but I don’t know of any, and my own surgical centre and AFAIK the nearest transplant/PH unit don’t. Seems a lot of testing for modest treatment options? Is it cost effective?
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