Irishman abroad /Intensivist at RPAH/Clinician first and foremost/Love golf/Opinions obvs my own
Limerick🏌️Lahinch☘️Sydney🇮🇪
Joined November 2012
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Mark Lucey retweeted
The overnight CT abdomen was “nonspecific colitis. No drainable collection. Follow clinically.” I signed it at 1:08.
At 5:41 the surgeon was already in the corridor outside OR 3. He did not ask for an addendum. He forwarded one axial from the bottom of the stack and wrote: “Why is there oral contrast in the peritoneal cavity?”
I had called that streak dependent debris. I had not scrolled past the kidneys.#MedX 👇
Mark Lucey retweeted
NASA told the world that, on July 19, 2013 a spacecraft would be photographing Earth from Saturn.
They published the exact time. They asked everyone on the planet to go outside and smile at the sky.
Thousands of people did.
This is the photo it took.
If you were alive in July 2013, you're somewhere in this picture.
From 898 million miles away, the universe waved back.
Mark Lucey retweeted
NASA HAS RELEASED OVER 12,000 IMAGES OF THE ARTEMIS II MISSION.
Unbelievable perspectives captured by the Crew! The aurora on the eclipse is incredible.
Mark Lucey retweeted
While zooming in on the Moon during daytime, the International Space Station was captured passing directly across its surface a rare and perfectly timed moment.
Readers added context they thought people might want to know
The video shows the ISS crossing the Moon over several seconds, but real transits last 0.5-3 seconds max due to its orbital speed of ~17,500 mph. This inconsistency indicates the footage is not authentic. Similar space videos have been identified as AI-generated fakes.
transit-finder.com
astronewton.com/blog/capturing…
futurism.com/artificial-int…
Mark Lucey retweeted
💧 DKA resuscitation: Normal Saline vs Ringer’s Lactate, does it really matter?
For decades, 0.9% NaCl has been the default fluid in diabetic ketoacidosis.
But… is it still the best choice?
🧪 New randomized ICU data (2025-2026)
👉 88 patients with severe DKA
👉 Ringer’s Lactate (RL) vs Normal Saline (NS)
👉 Same insulin protocol
📊 Primary outcome: DKA resolution at 48h
➡️ No difference
• RL: 56.5%
• NS: 50%
(p = 0.66)
⚖️ So… clinically equivalent? Not exactly.
The physiology tells a different story 👇
🧠 What RL does better
Compared to NS:
✔️ Higher bicarbonate early
✔️ Better potassium levels
✔️ Lower chloride at 48h
➡️ Translation:
• Less hyperchloremic metabolic acidosis
• Lower risk of hypokalemia
• More physiologic acid-base recovery
⚠️ What NS still does
❗ Same DKA resolution speed
❗ Same ICU stay
❗ Same mortality
➡️ So endpoints look “equal”…
…but physiology is not.
🚨 Why this matters in real ICU practice
Hyperchloremia is not benign:
• Worsens metabolic acidosis
• Increases respiratory workload
• Promotes renal vasoconstriction
• Delays recovery
And hypokalemia?
• Arrhythmias
• Insulin resistance
• Delayed metabolic correction
🧬 Clinical interpretation
This is not about:
❌ “Which fluid resolves DKA faster?”
This is about:
➡️ Which fluid creates a better internal environment for recovery
🔥 Take-home message
👉 NS is acceptable
👉 RL is physiologically smarter
➡️ Especially in:
• Severe acidosis
• High chloride states
• Patients at risk of hypokalemia
📚 Trifi A. et al. (2025)
Medicina Intensiva
doi.org/10.1016/j.medin.2025…
ALT
Mark Lucey retweeted
The face of someone who’s devoted their life to service, science and space exploration needing to listen to some draft-dodging, out-of-shape bozo brag that he easily could’ve been an astronaut.
Mark Lucey retweeted
Hello, Moon. It’s great to be back.
Here’s a taste of what the Artemis II astronauts photographed during their flight around the Moon. Check out more photos from the mission: nasa.gov/artemis-ii-multimed…
ALT A crescent Earth setting behind the Moon\u2019s horizon. Credit: NASA
ALT Earth setting behind the Moon as seen by the Artemis II crew. Over half the left side of the image is filled by the gray lunar surface, pocked with craters. Credit: NASA
ALT A close view of the Moon. Jagged circles of craters dot the gray surface, fading to dark on the left side of the image. Credit: NASA
ALT A crescent Earth setting behind a hemisphere of the Moon. Credit: NASA
Mark Lucey retweeted
A dramatic rescue outside Dingle harbour. 14 crew airlifted to safety from a stricken trawler. Impressive operation by Irish coastguard in extremely difficult conditions. Trawler is French with Portuguese and Indonesian crew.
Mark Lucey retweeted
‼️ THE BONDI HERO ‼️
Ahmed El Ahmad, a 43yr-old father-of-two fruit shop owner.
After so bravely jumping on the first terrorist, he was then shot twice by the second terrorist, and is now being treated in hospital but expected to be OK. Thank you Ahmed. 👏👏
Mark Lucey retweeted
Lucy Zelic didn't hold back when Stephen Conroy arrogantly defended family reunion entitlements for politicians👏
Mark Lucey retweeted
America’s loss will be Europe’s, Africa’s and Australasia’s gain. theguardian.com/us-news/2025…
So good 👏👏
The Australien Government has made an ad about the Social Media Ban for Under-16s, and it's surprisingly honest and informative. #auspol
Mark Lucey retweeted
Albanese and Labor are completely out of their depth on this social media ban.
There are countless unacknowledged consequences - no research, no foresight, no understanding of what they’re breaking.
#insiders
Mark Lucey retweeted
So, should beta-blockers be used after myocardial infarction in patients with LVEF >40%, and should they be stopped in those already taking them?
According to this sub-analysis of the REBOOT trial, withholding or withdrawing beta-blockers at discharge was not associated with increased short-term or recurrent ischemic events. The authors conclude that not prescribing beta-blockers after an uncomplicated myocardial infarction does not raise acute ischaemic safety concerns, and discontinuation in chronic users does not produce an ischaemic rebound. These data challenge current 2023 ESC recommendations advocating beta-blockers to reduce reinfarction and ventricular arrhythmias in patients who present with LVEF >40% after an acute myocardial infarction.
Article: eurointervention.pcronline.c…
Editorial: eurointervention.pcronline.c…
Mark Lucey retweeted
Why does the Albanese govt seem to have so much to hide & seem so afraid of scrutiny?
Transparency, different perspectives & robust policy debates build a stronger democracy.
This culture of secrecy is deeply concerning & risks repeating failures of administrations past like Robodebt.
We need safeguards & better practices to document govt decision-making in the digital age so our integrity doesn’t disappear along with the signal messages.
thesaturdaypaper.com.au/news…
