Discover and read the best of Twitter Threads about #Clinicians

Most recents (10)

I usually tweet about #obesity but since I recently had a pt with type 2 #diabetes go from 100 units/d insulin to 0 with tirzepatide, this is a good time to review #insulin management when you start a GLP1 / GIP

#endocrine #endocrinology #research #clinicians
1/
SURPASS-5: tirzepatide + basal insulin vs. placebo

Method: If baseline A1c<8, ⬇️long acting insulin dose by 20% at start of study

Result: At end of study, insulin was ⬇️11% for 15-mg tirzepatide group vs. ⬆️75% for placebo

jamanetwork.com/journals/jama/…

2/ Image
SUSTAIN-5: semaglutide 1.0 + basal insulin vs. placebo

Method: If baseline A1c<8, ⬇️long acting insulin dose by 20% at start of study

Result: At end of study, insulin ⬇️15% for 1-mg semaglutide group vs. ⬇️4% for placebo

academic.oup.com/jcem/article/1…

3/ Image
Read 7 tweets
Here I go again:
ER visits for #CovidIsNotOver are declining.

That is usually followed by a decline in hospitalization.

I know it is unpopular to talk of declining numbers, but that is what I am seeing.

We should see a 50-75%+ decline in hospitalization over the next 8 weeks.
COVID is not mild.

ER visits are going down and hospitalization may peak between 45K-55K-I posted this before

It was similarly unpopular in January when I said hospitalization will go down in February '22 down by 80%

Others were calling for end of time
The one indicator that I have touted since the pandemic began is ER visits. It is useful to look at all indicators.

It has proven to be more accurate than other indicators, particularly for severe disease, hospitalization, and critical disease (vents, respiratory failure/arrest)
Read 4 tweets
Notes from my book: Receiving many messages, DM’s & emails over ‘safeguarding’. I have worked in this industry for 30 years. Safeguarding chapter: #MentalHeath professionals are human & make mistakes, because they are human. They are first & fore-mostly trained in #safeguarding
Their ethos is to ‘Do No Harm’. Most people don’t understand what this means. #Therapists & mental health professionals disagree on many issues. They are divided on what safeguarding means to them #Childsafety & #childprotection have always been fraught by #childsafety challenges
In 2015, I began raising #safeguarding concerns with My regulatory board & the #psychology organisations. These were serious concerns. Over those years, I was ignored, brushed off, #silenced or told it wasn’t a problem. The Australian Senate held an #inquiry into our regulatory
Read 25 tweets
I am ready to talk about the #silencing of over 25,000 psychologists in Australia with regards to the safeguarding of children. We are threatened, harassed, coerced to provide only one #therapy to children or else! They tried to force me into this I said NO. Any journalists???
I am ready to talk to journalists, lawyers, bloggers and am now writing a book on this topic/issue. I am ashamed of my colleagues and the board who wilfully ignore the immature prefrontal cortex, the autistic brain, and their own ethics and guidelines #rogd #gender #transgender
I have not been able to speak openly about this until now as I have been continually #silenced, harassed, threatened, coerced by other #psychologists #therapists, my board, governing agencies and other professionals. It’s time to reveal what is happening to clinicians worldwide
Read 60 tweets
Australian Judges to now oversee #transgender #teen treatment is a positive step forward and welcomed in order to safeguard children who are unable to give full #gillick #informedconsent theaustralian.com.au/nation/judges-…
Thank you @KLBfax for your #bravery and standing up for vulnerable children who deserve #safeguarding, should have been given full #gillick informed consent and should have had their immature prefrontal cortex, as a consequence of child development, taken into consideration
This decision supports the UK, Finland, and Sweden in an international shift towards caution for #children and safest ethical medical practice. The Australian #gender clinic remains unidentified at the moment
Read 56 tweets
I am trained in #developmental #psychology and #neuroscince. I have been screaming the #teenagebrain is #underreconstruction from the rooftops! Am totally ashamed of my peers who wilfully ignore this. #neuroplasticity #frontallobes #psychologists #gender #rogd #trans #detrans
The teenage brain is under reconstruction. The prefrontal cortex is not fully developed until minimum aged 25. A bit longer for males. The prefrontal cortex is largely responsible for: decision making, planning, organisation, focusing, impulsivity, aka executive functions
Managing emotions, predicting consequences of one’s choices and moderating social behaviour. This is #science #facts Anyone who says otherwise is brainwashed by #ideology Shame on any professional who ignores this #gender #trans #detrans #shame
Read 46 tweets
Will we EVER learn about #PublicHealth?
3rd wave “expert” committee is nearly-ALL #Pediatricians (to keep Devi Shetty’s non-#evidence-based assertion on #children will be entirely affected), #AllMale #Manel, nearly-all #clinicians headed by #PrivateSector #Cardiologist
I request this committee members:
- Please QUESTION Devi Shetty’s credentials to lead this
- Please hold to account #Manel #AllMale membership
- Please include #RuralHealth #CommunityHealth #PublicHealth
- Expertise is NOT only CLINICAL; also social; include grounded voices
Unfortunately no time & bandwidth; but putting this out there
We need:
- campaign for a DIVERSE expert committee including #Citizen #CommunityEngagement #Dalit #Adivasi voices
- Devi Shetty’s position as Chair is NOT tenable; appoint a #PublicHealth expert in his place
Read 6 tweets
Woah..that was freaky but familiar. Was lying down & decided to get up to take pain meds for #endometriosis and #fibroids and it felt as painful to get up as the day after surgery. In kitchen, sweating, lightheaded. Quickly squatted to avoid passing out holding onto fridge door
..which swung open..but I did not fall. Then once head feeling better, stood up long enough to take meds...then walked, wobbly and lightheaded to chair. I can't quite feel my palms but that will come back. This probably gets to be called 10/10 pain..but maybe really an 8/10
Great..and a migraine too..scotoma.. taking a migraine med and lying down. Man, when it rains it pours.

Mother Nature is such a misogynist.

SO glad I did not decide to rent a car and try to go Finger Lakes this weekend to see peak foliage.
Read 88 tweets
The RED Talk on The #Business and #Science of #Healthcare is now live! Still time to join us at ruralpolicy.group/red.
The next big issue facing NICE & #healthcare will be our relationship with the European Medicines Agency after Brexit; it will impact our #medicines research, trials. We could see a dramatic reduction in research, access to medicine and disrupt the supply of meds - @steve_mccabe
The British #taxpayer makes a phenomenal contribution to the development of new #drugs - but these can then be prohibitively priced. We need to improve access to new medicines and there is a question around cost, access and funding. @steve_mccabe
Read 24 tweets
#Ayurveda #Herbal #real #Tales
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Saw 64y old #patient with #jaundice and severe #itching all over #body (called #cholestatic #hepatitis) in OPD. Went to 3 other #hospitals prior, always evaluated for #liver and #bileduct #Cancer. Always cancer tests #Negative. Liverbiopsy👇 Image
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Biopsy shows severe #bile stagnation (#cholestasis) in liver #cells and bile-ducts with #inflammation and #swelling of livercells (#hepatocyte) - classical picture of cholestatichepatitis. CT of liver normal, #MRCP (to see bile ducts) - normal #livertwitter #pathology
CAUSE👇 Image
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Patient has #diabetes. Tired of #insulin #diet control. #Ayurvedic #physician advises - stop insulin, start #natural side effect free #treatment. Gives these #CAPSULE . After 6 months on #tablet - liver injury and symptoms start. #nutrition deprived, sugar controlled. #MedEd
Read 6 tweets

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