Discover and read the best of Twitter Threads about #GITwitter

Most recents (24)

1/ It's #EBGI Tweetorial 🧵 w/ @aileenbui!

“Drainage for Infected Pancreatic Necrosis – Earlier Is Not Better"

📜 Summary:
📰 in @NEJM:

@SunilAminMD @KumarShria
@MarcBesselink @pancreatitis_nl
#GITwitter #MedTwitter
2/ Let’s start with a poll:

40 yo 🙎🏻‍♂️ w/ worsening signs of sepsis 14 days after initial dx of acute pancreatitis. CT A/P w/ gas in the area of pancreatic necrosis.

What do you do?
3/ Importance

🔸1/3 of pancreatic necrosis ➡️ infected (after ~10 days)
🔸Infection 🦠 ➡️ 20-30% mortality
🔸Management is usually step⬆️, see 👇
🔸But, the timing of catheter drainage is unclear
Read 8 tweets
Intestinal Ultrasound
#GITwitter #MedEd

We will start with normal Normal #IUS #anatomy superficial mucosa (white) ...

In ileocecal #Crohn’s disease, typically all bowel wall layers are involved. #IUS shows marked mural thickening, predominantly in the terminal ileum, cecum & appendix can also be involved.

🔗:… Image
Bowel wall thickening is most prominent in the hyperechoic submucosal layer, representing deposition of fat and fibrous tissue as a result of chronic bowel inflammation Image
Read 56 tweets
🚨 #CME Thursday 🚨

This week at #TumorBoardTuesday @W_Park_MD discussed FGFR inhibitors in #BiliaryTractCancer #CCA...and how to find FGFR fusions!

Check out the questions below, and tap the link to claim your free #CME...and stay tuned for a special edition of case wrap up! Image
#PostTest Q 1️⃣ #CME #TumorBoardTuesday

🤔 What is a molecular biomarker for an FDA approved🎯💊in #Cholangiocarcinoma

#OncTwitter #GeneTesting #CCA
#PostTest Q 2️⃣ #CME #TumorBoardTuesday

🤔 To detect 🧬 gene rearrangement what is the preferred method❓

#OncTwitter #GeneTesting #CCA
Read 14 tweets
1/9 #TumorBoardTuesday Thursday Case Wrap Up🎀

⏰ for #TBT Case Wrap Up!

We looked at dx and tx of Carcinoma of Unknown Primary (#CUP), including how 🧬 can change tx.
There was a lot to learn–we captured what we could of the discussion here:…
2/9 #TumorBoardTuesday Thurs Case🎀
#CUP is complicated!
✅Comprehensive approach needed, including:
H&P,🔬, 🩻, 🧬
✅Overall inc of CUP is ⬇️–many liver CUP being recognized as cholangio
✅NGS can help augment the w/u
✅STK11= frequently mut in lung; ⬇️response to IO Image
3/9 #TumorBoardTuesday Thursday Case🎀

@LaurenBzak’s case: Pt p/w solitary 🧠 lesion ➡️ poorly diff adenocarcinoma. But–not a primary CNS malignancy. NOTHING outside 🧠on CT or PET.

🧐What should we do next?

👍Detailed H&P (smoking hx)
Read 12 tweets
#LowFODMAP Diet, restriction phase x 2 wks done!😅

✅Hardest #GIEmpathyInitiative yet (5 pts!)
✅Worth it b/c 🤯reflections in🧵⬇️

Disclaimer: LFD is🙌for some w/ #IBS but NOT good fit/safe for all

@Gut_BMJ 2021 Network MA on LFD in IBS @alex_ford12399
1⃣Hardness of diet complexity:
✅❓rhyme/reason to👍vs.👎fruits/veggies
#Glutenfree🚫always safe (fillers!)
✅ If packaged you just avoid b/c label reading =😱
✅🙌@KateScarlata_RD for LFD label reading tips
✅Apps @MonashUni app ($8), FastFodmap(free)
2⃣Hardness of diet behavior change:
✅Eating out = embarrassing to be "that person" + 😱spice situation
✅NEED coach (dietitian) to guide/remind of goals
✅If eat like🗑️at baseline,❓sustainability ➡️maybe why many patients preferred @NICEComms diet…
Read 9 tweets
🌬️ Breath testing for #SIBO: everything you need to know! 🎈 😮‍💨 💩 🦠 🐄 📈

#MedTwitter #medicine #science #GITwitter #GI #microbiome #IBS #diet #nutrition…
To kick things off: how do you diagnose #SIBO?
#SIBO is a disorder characterized by excessive colonization of the small intestine by organisms usually found in the colon, especially Gram-negative bacteria.

(NB: the more we learn, it seems the *type* of bacteria is more important than the *number!*)
Read 26 tweets
🆕European guidelines on fecal incontinence, which affects about 8️⃣% of people. 💩

#MedTwitter #medicine #GITwitter #GI #Surgery #SurgeryTwitter

Read 11 tweets
@MondayNightIBD @DCharabaty @pfizer @JanssenUS @TakedaPharma @BonumCe 3/ 👋@MondayNightIBD crew
#MentalHealth in #IBD:
⬆️Anxiety & depression
✅Patients experience medical trauma & Post-traumatic stress symptoms (PTSS)

👉Treat-to-target approach inc.⬇️disability & ⬆️QoL
⚠️Yet #MentalHealth is often overlooked in #IBD
#MondayNightIBD #GastroPsych Image
@MondayNightIBD @DCharabaty @pfizer @JanssenUS @TakedaPharma @BonumCe 4/ 📌#Depression in #IBD
👉 21% of #IBD pts vs 13% healthy pts

⬆️ 90-day readmissions
⬆️ Surgeries
⬆️ Unnecessary CT-scans/CLN
⬆️ ED visits
⬆️ Annual cost ~$18k

🚨Bi-directional effect
⚡️Poor #MentalHealth 🔁 Poor self-mgmt
⚡️⬆️ inflammation 🔁 ⬆️ depression
#MondayNightIBD Image
@MondayNightIBD @DCharabaty @pfizer @JanssenUS @TakedaPharma @BonumCe 5/ #Anxiety in #IBD
👉 19% of #IBD pts vs 10% healthy pts

🚨Bi-directional effect🚨
⬆️Anxiety = risk factor for IBD & IBD = risk factor for anxiety
⬆️Inflammation 🔁 ⬆️Anxiety
#MondayNightIBD #GastroPsych Image
Read 16 tweets
MedNews Week Conference - Infectious Disease & Gastroenterology - Dr. Paul Feuerstadt (Yale)…
Happening now!

A discussion about Gastroenterology & the latest developments chronic diarrheal syndrome from one of GI’s global leaders-- Dr. Paul Feuerstadt from @Yale (@DrPaulGastro)

Youtube stream:

Clubhouse link:…
Read 6 tweets
As promised, here's my slide set on "Landmark trials in Hepatology 2021"
A lot of great research got left out due to ⏰(15min!)
Tx to #livertwitter #GITwitter.
A 🧵below
(Animations removed!)
Scheme of presentation
Final cut pro☺
Read 12 tweets
Read 3 tweets
@DCharabaty @MondayNightIBD @southasianIBD @P_DeepakIBDMD @IBDimmunology @nehagastrord @ibdesis @ownyourcrohns @FITWITMD @crohnsbabble @rebelliousgut @ibdseb @drsumitbhatia @DrAnjaliPandit A1/n One of the most difficult clinical situations which a clinician could encounter: the two entities are remarkably similar
At our center almost half of such situations the underlying condition is ITB and in the rest half CD
Crossed fingers
Read 9 tweets
¿Es correcto compartir imágenes médicas de pacientes en redes sociales? Y de ser así, ¿cuál es la manera adecuada, ética y legal para hacerlo? Este comentario publicado en Nature brinda una excelente orientación. #MedEd #MedTwitter #GITwitter #ENARM #InvestigaMX Abro hilo (1/5)
En general, las regulaciones mundiales no consideran inapropiado compartir imágenes médicas públicamente en congresos, clases o redes sociales, siempre que sea con fines de docencia, Investigación o intercambio de ideas Y SE MANTENGA SIEMPRE LA PRIVACIDAD DEL PACIENTE. (2/5)
Una imagen se considera inapropiadamente compartida si es con fines distintos a los arriba descritos (por ejemplo, hacer mofa de un diagnóstico o de la apariencia de un individuo), o si incluye total o parcialmente datos personales del paciente (cara, nombre, apellido, etc).(3/5)
Read 7 tweets
@MondayNightIBD @DCharabaty @janssen @pfizer @TakedaPharma 2/ 📸 Faculty disclosures & CME certification ℹ
Want a #CME certificate? → ℹ️
#MondayNightIBD Image
@MondayNightIBD @DCharabaty @janssen @pfizer @TakedaPharma 3/ 😭 most pts are NOT getting safe 💉 like flu, pneumonia & HepB.
🤷‍♀️ Why?
🚫Many GIs won't/can't give 💉
❓Many PCPs don't know what to give
📞 Better communication is needed

Who do you think should make vaccine recs & where should pts w/ #IBD get 💉?
@MondayNightIBD @DCharabaty @janssen @pfizer @TakedaPharma 4/ pts w #IBD , esp if on ⚠️immunosuppressants (IS), at ⬆risk of (preventable) infections, so #vaccination is 🗝️
Infection in IBD = ⬆hospitalization ⬆ 🏥 stays ⬆costs & ⬆mortality.

Despite their benefits, vaccination rates remain LOW.

#MondayNightIBD Image
Read 19 tweets
🔴🟠🟢 Hepatology Bedside Pearls

Curvoisier-Terrier Sign!

(Arun's Gastro Aphorism☺
It's unlikely that you have finished Gastro rotation and never heard of this!)
🟠What's in a name?
❌a.k.a Curvoisier's Law (well hey, there ain't any laws in medicine!)

✔Curvoisiers gallbladder ( A Verghese, Lancet 1986)

✔Curvoisiers Sign

✔✔Curvoisier-Terrier Sign ( personal preference!)
🟠 What exactly is it?
"In a patient with painless jaundice, a palpable gallbladder is unlikely due to stones"
Most likely malignancy
Read 16 tweets
🥊 #HitMeWithYourBestShot: Reguiero vs Siegel

@MRegueiroMD➕anti-TNFs "Why wouldn't we use anti-TNF as first line #IBD therapy?!"

#AIBD2021 @IBDConference @DrCoreySiegel ImageImageImageImage
Anti-TNFs are EFFECTIVE ImageImageImageImage
We know a LOT about #TDM in anti-TNFs ImageImageImageImage
Read 23 tweets
Alguna vez te has preguntado el origen de la palabra cáncer? Sirva este colangiocarcinoma para resolver la pregunta. Spolier alert si vas directo al tweet 5 de este hilo.
#livertwitter #GItwitter #medEd #cancer #cholangiocarcinoma #tweetorial #hilo Image
Cáncer es una palabra que proviene del griego "karkinos", que significa "cangrejo". Esta, a su vez, proviene de "karkah", cangrejo en sánscrito y de su raíz "kar" que significa duro. Image
Los primeros en denominar a los tumores y otras lesiones ulcerosas como "karkinos" fueron los griegos. Del griego también deriva "carcinoma" ya que el sufijo "oma" hace referencia al tumor, y significa tumor duro o maligno. Image
Read 5 tweets
If you eat yourself, will you get hyperkalemic?

Sorry, let me rephrase:

Can upper GI bleeding cause hyperkalemia in predisposed people?

I feel like I’ve gotten that vibe from a couple patients. I can’t find any reports from others.. but I can think of a mechanism...

Blood contains a lot of protein.

When a significant amount of it is introduced into the proximal GI lumen (and some of it absorbed), it can elevate your BUN, or trigger hepatic encephalopathy.

The concentration of potassium in RBCs is ~100 mMol, meaning 100 mEq/L. If you start at a hematocrit of 40 and bleed 20% of your blood volume into your stomach...

That’s ~1 liter blood = 400 cc of red cells = 40 mEq of potassium.

Read 9 tweets
Evidence-based approach to #IBS (C and D) from @LinChangMD at @AmCollegeGastro #ACG2021

#GITwitter Image
FGIDs ▶️ DGBIs 🧠 Image
#IBS diagnosis Image
Read 25 tweets
LFD studies are not great (small n, high bias, heterogeneity), but all the studies do suggest that the LFD is a good treatment option for #IBS and can improve global symptoms, pain, and bloating
App-based low-FODMAP #diet was found to be more effective (71%) than antispasmodic therapy (61%) in #IBS, even 6 months out
Read 12 tweets
Functional abdominal pain (centrally mediated abdominal pain syndrome) by Dr. Brian Lacy at @AmCollegeGastro #ACG2021

#GITwitter #GI #FGID #DGBI
A common scenario!
Read 23 tweets
Rationale for #TDM

All TDM should be performed in the context of the clinical disease activity and severity -@IBDMD
Philosophy of #TDM
Read 23 tweets

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