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: bit.ly/3kONaEQ
📰 in @NEJM: bit.ly/3MWe4X5

@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) ...
#IBDtwitter

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.

🔗: ncbi.nlm.nih.gov/pmc/articles/P… 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
👉🏽 ALL CME🔗 integrityce.com/tbt

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

#OncTwitter #GeneTesting #CCA
#PostTest Q 2️⃣ #CME #TumorBoardTuesday
👉🏽 ALL CME🔗 integrityce.com/tbt

🤔 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:

twitter.com/i/events/15089…
2/9 #TumorBoardTuesday Thurs Case🎀
Take🏠:
#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)
👍PATH CONSULT!
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
pubmed.ncbi.nlm.nih.gov/34376515/
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 gastrogirl.com/626/
✅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
cghjournal.org/article/S1542-…
Read 9 tweets
🌬️ Breath testing for #SIBO: everything you need to know! 🎈 😮‍💨 💩 🦠 🐄 📈

#MedTwitter #medicine #science #GITwitter #GI #microbiome #IBS #diet #nutrition

cghjournal.org/article/S1542-…
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

@my_ueg
🔑
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) twitter.com/i/broadcasts/1…
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: clubhouse.com/event/maWRBOp8…
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 bit.ly/3IbTRdB
#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
#MondayNightIBD

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...

1/
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.

2/
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.

3/
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!
Definitions
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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