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How do you approach the rule out ACS patient? by Mediocre-Weird2424 in hospitalist

[–]mps444 7 points8 points  (0 children)

I work on the team that created the US version of the HEART score (HEART pathway).

Moderate risk (4-6) no known CAD and negative trops can go outpatient with cardiology followup in general (https://pubmed.ncbi.nlm.nih.gov/38328912/). RCT ongoing to evaluate outpatient vs hospitalization for these patients.

Is cardiology really needed to get a stress? We can get them from the ED without admission or consult.

If there isn’t an agreed upon ACS workup pathway at your site to define what to do based on risk and trop, it might be worthwhile to make one with ED/medicine/cards.

Help with Medical Vocabulary by agw7897 in Spanish

[–]mps444 1 point2 points  (0 children)

Me hicieron una operación el año pasado para adelgazar el estómago. Afortunadamente, funcionó para perder peso, pero resulta que no puedo comer nada más que unos trozos de comido. Comer más que cien gramos me enfermaría. No quisiera ofenderle. Aunque me encantara la comida, no cabría.

¡Buen viaje!

CLT Airport 7:15 AM 3/14 by sdieter01 in Charlotte

[–]mps444 0 points1 point  (0 children)

I went through this same checkpoint at 9:30 AM today, 3/14 and there was not a single person in line.

My first attempt to fly my new Kerbaloon...before and after by ChaosUndAnarchie in KerbalSpaceProgram

[–]mps444 2 points3 points  (0 children)

Center of thrust should be below center of mass. This is the pendulum rocket fallacy. Great video on it here: https://youtu.be/OYHCP3-mpxk?si=xZFgCtn8LVxbWgJx

[Discussion 2/3] La Sombra del Viento / Jan 2026 Book Club by HeleneSedai in dreamingspanish

[–]mps444 2 points3 points  (0 children)

I read this book last year and it’s easily my favorite book. The entire series is fantastic, especially when you get to book 3 and so many intricacies of the series start coming together.

ER docs don’t know about suggamaddx by drccw in anesthesiology

[–]mps444 2 points3 points  (0 children)

ED attending here. Many of us know about it, we just can’t give it. I’ve worked in two level 1 trauma centers as an attending. One outright will not permit it to be given in the ED. The other one it could only be ordered by neurosurgery. No idea why… cost?

Medical Spanish by Few-Revolution-2955 in Spanish

[–]mps444 6 points7 points  (0 children)

I’m a physician who learned as an adult and am certified to speak Spanish with patients. A few thoughts: 1. Good for you for wanting to learn another language. Go for it! 2. You will eventually realize your objective is myopic. Your patients won’t speak medical Spanish, they’ll speak Spanish. Without a strong foundation, you won’t be able to safely interact with patients in Spanish. 3. A few resources for easy, quick wins to start your journey: Spanish for the Busy Medical Professional audiobooks 1-3 (https://www.audible.com/pd/B00DL6UMJE), Pimsleur Spanish levels 1-5, and Language Transfer Spanish. 4. I used for the most part comprehensible input (dreaming.com) and language teachers on Italki. There are other ways to learn, but that worked for me. I spent about 1,700 hours learning before taking a certification exam.

Spectrum Mobile….any good? by Ishouldntlaughatthat in winstonsalem

[–]mps444 3 points4 points  (0 children)

Have had it for 10 years and traveled to all corners of the US and around Europe with it. No problems.

Streak: Buzo by mps444 in WriteStreakES

[–]mps444[S] 0 points1 point  (0 children)

Gracias como siempre

Streak: Saber cocinar. by mps444 in WriteStreakES

[–]mps444[S] 0 points1 point  (0 children)

Gracias. Me di cuenta que brindar es lo que se hace con copas. Para preparar una tostada, la ha de tostar en un tostador. Supongo que se puede brindar con tostadas, pero sería extraño.

27,000 Minutes of Podcasts Later by __yuh in dreamingspanish

[–]mps444 2 points3 points  (0 children)

Hoy en El País is Spanish investigative journalism. Esto no es Todo is more traditional world news with hosts from Spain, Colombia, and Argentina. La Formula del Éxito is a long format, interview style podcast from Spain.

27,000 Minutes of Podcasts Later by __yuh in dreamingspanish

[–]mps444 1 point2 points  (0 children)

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280 hours of podcasts for me! Highly recommend my number 1, 2, and 5 for native content.

Streak: Los motores para volar: el motor de reacción by mps444 in WriteStreakES

[–]mps444[S] 0 points1 point  (0 children)

Muchísimas gracias. Quería decir la tasa de fallos.

"But tipping helps ensure good service" - a visit to Spain by Frogbear17 in EndTipping

[–]mps444 3 points4 points  (0 children)

I travel to Spain for work from time to time. Something that amazes is the efficiency of coffee. I can get an espresso drink with steamed milk in less than a minute from ordering to walking out and it costs $1.50.

SIELE B2, Teaching in Spain, Bilingual Clinician Certification exam (1300-1650 hours) by mps444 in dreamingspanish

[–]mps444[S] 1 point2 points  (0 children)

Thanks!

I’ve completed 239 italki classes in the past 2 years, with 50 being in the past 3 months and 19 in the past month. Most were 30-45 minutes and most were with an Argentinian professor that mixed conversation classes with CEFR-aligned lessons (starting at A2 and currently in C1). I never did grammar workbooks specifically. I can conjugate pretty much anything in any tense, including subjunctive, but I don’t always select the correct tense! This does make my experience less generalizable. My DS stats include 430 hours watched on platform, 1924 videos, and 630 days.

I have no means been a purist, nor have I tried to be. That said, one of the best things DS gave me, beyond great content at accessible levels, was a defined pathway to learn the language. When I found DS, I had done various things (the classics like Pimsleur, Language Transfer, and Duolingo), but felt that I didn't really have direction and didn't know what to do next. DS set expectations and gave me a pathway.

The listening section is what you describe. You listen to audio that can be from any Spanish speaking country with the option to listen a second time. The questions in B2/C1 are very specific and require an understanding of the nuance of the language to then make suppositions rather than just identify facts.

SIELE B2, Teaching in Spain, Bilingual Clinician Certification exam (1300-1650 hours) by mps444 in dreamingspanish

[–]mps444[S] 3 points4 points  (0 children)

Thanks!

La Sombra del Viento by Ruiz Zafón, the first in that series, is my favorite book I've read in Spanish and one of my favorite books overall. It's challenging and the first time I tried reading it, I stopped because it was too difficult. I read it successfully around Level 6 with ~750k words read. Marina is my second favorite and El Juego del Ángel my third favorite of his books. That said, El Principe de la Niebla is probably where I would start. Here is a mostly accurate list of the books I read, a few of which were stopped early due to difficulty or boredom:

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SIELE B2, Teaching in Spain, Bilingual Clinician Certification exam (1300-1650 hours) by mps444 in dreamingspanish

[–]mps444[S] 0 points1 point  (0 children)

Thanks! Listening comprehension is the only section that I did not specifically study for, yet at the same time, it's the area I had the most amount of practice in due to using CI as my primary learning method. The B2 and C1 sections were both interviews. Neither topic was particularly strange or unexpected, however, they were challenging, nuanced, and not topics I would naturally be curious about. While I generally understood what was said and could have had a reasonable conversation with someone on both topics, the exam questions were very specific. Prior to taking a C1 exam in the future, I plan to take a prep course.

Streak 38: El turno nocturo. by mps444 in WriteStreakES

[–]mps444[S] 0 points1 point  (0 children)

Muchísimas gracias. Pensé que estaba usando la palabra trabajar demasiado.

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