Discover and read the best of Twitter Threads about #MDs
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Many people with mental health conditions rely on medications to manage their symptoms, but these medications often come with metabolic side effects like weight gain, type 2 diabetes, and sexual side effects. (1/8)
Many people complain of feeling less "bad" but also emotionally flat. As someone who does couples therapy, I can tell you these side effects come into the session with the couple.
There are costs to these side effects. (2/8)
There are costs to these side effects. (2/8)
In addition to the financial cost of medications, these side effects can come at a high quality-of-life cost, which is why many people don't stay on them, even when they're helpful. (3/8)
The Bazuki Metabolic Neuroscience Initiative supported by @BaszuckiGroup means good things for mental illness and neurological disorders. This is a thread to learn more. 𧔠(1/7) #neuroscience #metabolism #metabolicpsychiatry
@BaszuckiGroup The initiative will have three arms: clinical, mechanistic, and computational, and will serve as a hub for coordinating funding and research in this area. (2/7) #brainhealthmatters #research #neuroscience
@BaszuckiGroup The initiative will also conduct its research in these three areas, including foundations, Frontiers, and Technology development. (3/7) #research
When I took on leadership of the #CHIP clinic @DanaFarber @DanaFarberNews, I was #bookedandbusy lots of #CHIP & #CCUS had been diagnosed since we rolled out our clinical NGS panel in 2014/15. But the uncertainty (the âindeterminate potentialâ) was disquieting.
Imagine someone hands you a grenade & says: donât worry most don't explode. But some do. But most explosions don't kill you. But some do. We donât know which grenade you have. Oh, and you must hold it forever
That's a hematologists diagnosing CHIP/CCUS, precursors to #MDS & #AML
That's a hematologists diagnosing CHIP/CCUS, precursors to #MDS & #AML
In truth, we're not totally compass-less. @jaiswalmdphd noted the association between high RDW & progression to myeloid neoplasm (MN) in early work.
Luca Malcovati & others noted risk was genotype specific: splicing factor mutations are higher risk than DNMT3A mutations
Luca Malcovati & others noted risk was genotype specific: splicing factor mutations are higher risk than DNMT3A mutations
K-562. It was the first human cell line I ever tried to grow in culture, during training @MayoClinic. It was also the first immortalized myeloid leukemia #cellline, published @BloodJournal way back in 1975. What does the K stand for? #HematologyTweetstory 37 is on cell lines./1 
K-562s were derived from a the pleural effusion of a 53 year-old woman with #CML in blast crisis, so they have Ph+/BCR-ABL. She'd been treated with busulfan for 3 years & pipobroman for a year (limited & crummy Rx options back then), and died 9 days after cell collection./2
The K in K-562 is for âKnoxvilleâ, where the University of Tennessee & precursors have resided since 1794. The 562? Maybe a vial name. Only Argentinian-born Drs. Carmen & Bismarck Lozzio @UTKnoxville knew; they isolated the cells & published in 1975: sciencedirect.com/science/articl⊠/3
And others.
"Need to effectively utilize #CNMs has never been greater," says Kohl from midwife.org
Finding a supervising provider may prove difficult.
Body of evidence has consistently shown that although these barriers do not improve care.
"Need to effectively utilize #CNMs has never been greater," says Kohl from midwife.org
Finding a supervising provider may prove difficult.
Body of evidence has consistently shown that although these barriers do not improve care.
Kohl:
"Time to follow the economics and evidence and remove supervision of practice"
Notes that team based care is the "future of #healthcare in the US"
"Time to follow the economics and evidence and remove supervision of practice"
Notes that team based care is the "future of #healthcare in the US"
Candidates for #NEET #MDS approach #SupremeCourt urging the seats allocated to them in Karnataka be recognised as valid. They contend that they are victim of circumstances and that Karnataka was responsible to issue the counselling schedule within the #DCIâs stipulated timeline.
Sr Adv Shyam Divan: I think the ASG is supposed to respond.
ASG Nataraj: The govt considered this but rejected. It will not be possible to make fresh admissions. Many MDS seats are lying empty through the country, if one request is entertained it will open a floodgate.
ASG Nataraj: The govt considered this but rejected. It will not be possible to make fresh admissions. Many MDS seats are lying empty through the country, if one request is entertained it will open a floodgate.
SC: What if state govt has alloted seats in Dec?
ASG: That the state govt has to deal.
It is a very dangerous trend that institutions are coming under A32 which is not available to them.
Adv Gaurav Sharma(DCI): The prayer is not to regularise those after cut of date.
ASG: That the state govt has to deal.
It is a very dangerous trend that institutions are coming under A32 which is not available to them.
Adv Gaurav Sharma(DCI): The prayer is not to regularise those after cut of date.
For the trolls who insist us #MDs, #scientists, #academics and #healthcareworkers are fascists/communists/nazis/ etc.
We absolutely DONT want more lockdowns (who does?)
We want to protect kids w #publichealth (isolation, testing, masks) until they can be #vaccinated
#COVID19
We absolutely DONT want more lockdowns (who does?)
We want to protect kids w #publichealth (isolation, testing, masks) until they can be #vaccinated
#COVID19
Schools had to be closed twice because cases exploded out of control. Far more disruptive for every parent, employer & society. Far more damaging for our kids mental health, education, & lives.
how have we gotten to the point where we canât agree to protect our own CHILDREN??
how have we gotten to the point where we canât agree to protect our own CHILDREN??
It is often said that Marie SkĆodowska-Curie died of "aplastic anemia." Try Googling it; you'll find many hits. But I am not so sure. She died on July 4th, 1934, at a sanatorium called Sancellemoz, in Passy, Haute-Savoie, France, after a long illness. #aplasticanemia #MDS /1
The 1937 biography by her younger daughter Ăve describes her final illness, including a consultation at Sancellemoz (postcard) by a "Professor Roch." That would have been Maurice Roch, Regent of @UNIGEnews & father of famous Alpinist AndrĂ© Roch who planned Aspen, Colorado./3
Here is how the daughter's biography describes that consultation. Mention is made of fevers and blood tests - rapidly falling WBC & RBC counts - and that X-rays were done. (The last thing she needed: more radiation!). Diagnosis: "Pernicious anaemia in its extreme form." /3
Justice DY Chandrachud led bench of #SupremeCourt to shortly hear a plea challenging the "unjust and infinite delay caused by the Medical Counselling Committee in announcement of the counselling schedule for NEET-MDS 2021
#NEET #MDS #counselling @indlawyer @advocate_tanvi
#NEET #MDS #counselling @indlawyer @advocate_tanvi
Read details of the petition here:
#supremecourt @indlawyer @advocate_tanvi #NEETMDSCOUNSELLING
barandbench.com/news/litigatioâŠ
#supremecourt @indlawyer @advocate_tanvi #NEETMDSCOUNSELLING
barandbench.com/news/litigatioâŠ
Justice Chandrachud: Sr Adv Vikas Singh says candidates who appeared for NEET MDS 2021 however there has been no update on counseling as a result of which valuable months of careers of students being wasted. issue notice. To be listed in two weeks
#supremecourt
#supremecourt
I see new debate is going to be whether the fact that the severe disease outcomes from #COVID19 occurred in the placebo arms (not vaccine) is notable or not, including biostatisticians on secondary outcomes & powering. You may see a bent on here from #MDs who are very happy
about this as they are the ones who worked in the hospital this year. But let's actually discuss for a minute why rolling out a vaccine in the middle of a pandemic is SO different than previous pandemics. You see on timeline above that 1st flu vaccine was introduced in 1936
18 years after the influenza pandemic. Vaccine not rolled out smack-dab in midst of pandemic before this! And look what is happening in UK with such fast roll-out of 2 mRNA vaccines AND an adenovirus/DNA vaccine (AstraZeneca) that also (like J&J) doesn't have the same efficacy
Hereâs a thread about the #nucleus⊠no, Professor Ernest Rutherford, not the atomic nucleus that you discovered with your alpha particles back in 1911.đ This is about *cell* nuclei and all their weird and wonderful forms, in blood cells and beyond. #HematologyTweetstory 31! /1
Cell nuclei were first drawn by Dutch microscopy pioneer Antonie van Leeuwenhoek circa 1719 (pictured), and discussed as distinct structures in 1804 by botanist Franz Bauer (below with green jacket), then clearly described in 1831 by botanist Robert Brown (below, with bowtie)./2
Brown first called the nucleus the âcell areolaâ â which suggests he may have observed nucleoli as well, although he didn't mention them (they would have been just at the limit of his microscope's resolving ability). Probably a good thing that term didnât stick, though.../3
Disappointing news in the #MDS world: #rigosertib INSPIRE trial in VHR HMA failure pts is negative: 6.4 months OS versus 6.3 in BSC arm. Still no good 2nd-line therapy for HR MDS. âŠâŠ@MDSFoundationâ© âŠ@aamdsifâ© âŠ@MikkaelSekeresâ© onclive.com/view/rigosertiâŠ
If we compare with the ONTIME rigosertib trial, also for HR MDS failed by HMA therapy, OS in BSC arm was similar to slightly better (6.3 vs 5.9 months) even though INSPIRE included only ostensibly the very highest risk patients. thelancet.com/journals/lanonâŠ
And it benchmarks with Thomas Prebet et al classic analysis of HR MDS after aza failure: 5.6 months OS, as reported in JCO @ASCO_pubs in 2011 - although there, the subset who got an investigational therapy (likely better PS etc) had median OS 13.2 months. ascopubs.org/doi/10.1200/JCâŠ
A follow-up to recent monster #HematologyTweetstory 22 on the names of all 71 @theNCI Cancer Centers: the National Comprehensive Cancer Network (@NCCN), which (especially outside the US) is sometimes confused w/ @theNCI, but doesn't get direct NCI funds./1 nccn.org/members/networâŠ
@NCCN was a mystery to me as a hematology-oncology fellow. What is it, exactly? A cancer center faculty club?đA quasi-cooperative group? I suspect I wasn't alone in my confusion. This thread will include some history & description - and will mention a few areas of controversy./2
#HematologyTweetstory 23: a thread on how the confusing "myelo-" nomenclature arose. Myelodysplasia, AML, myelofibrosis. Myeloma. Myelomeningocele, poliomyelitis, and other neurologic conditions. Osteomyelitis (depicted). They *sound* connected - but are unrelated. #MDS #MMsM /1
I think I first did a @PubMed search on âmyelodysplasiaâ around 1997, looking for a paper about #MDS marrow. But the search returned a bunch of articles about spina bifida, not about bone marrow. This was a surprise. The @SpinaBifidaAssn even has a seal named Myelo as a mascot./2
The linguistic connection in English (and other languages) between marrow and brain/spinal cord is unexpected, and results from a historical misconception./3
#HematologyTweetstory 8: Auer rods! These peculiar cell inclusions are a worrisome finding, defining an immature blast cell as one of myeloid lineage⊠and they are also probably mis-named. This image is from a chapter I wrote for a board review book @MayoClinic circa 2007. /1
Eponymous John Auer (1875-1948) was from Rochester, New York. He got his BS @UMich, started his medical training at @HopkinsMedicine in 1898, then moved to @RockefellerInst in 1903 where he worked on anesthesia (and also married Dr. Clara Meltzer, the daughter of his mentor.) /2
In 1906, in #AJMS, Auer described peculiar rod-shaped structures in the blood cells of a 21 y/o Spanish-American War veteran who presented to Oslerâs service @HopkinsMedicine with tonsillitis and epistaxis, and was found to have anemia and leukocytosis. Their diagnosis: ALL. /3
Time for #HematologyTweetstory 7: the origin and expanding use of the word âcloneâ, which describes an essential concept in cancer biology and hematology. This tale involves a global banana catastrophe, a nearly-blind dystopian novelist, and an excursion to the planet Kamino./1
In 1903, the year of the Wright Brothersâ first flight, a widely respected US Department of Agriculture plant breeder named Herbert J. Webber (1865-1946) was looking for a word to describe asexual propagation of plants by grafting or by transplant of cuttings./2
As a botanical concept, asexual propagation was certainly not a new one â a 6th century C.E. Alexandrian philosopher, John Philoponus, had described the process using the term clados (ÎșλΏΎÏÎœ, meaning âtwigâ or âbranchâ), the origin of the contemporary taxonomy term âcladeâ./3
#HematologyTweetstory #6: the âpawn ball megakaryocyteâ. Weâll revisit Dr. Frankenstein from Tweetstory #1, discover the origin of Santa Claus, and travel from Boston to Las Vegas â a flight the clever guys from the MIT Blackjack Team used to make every Friday. #hematopathology/1
âPawn ballâ megakaryocytes have 3 distinct nuclear lobes; this is abnormal. The first reference Iâve found that uses this term is a 1984 @BloodJournal paper by David Rosenthal & William C. Moloney (1907-1991). Dr Rosenthal @DanaFarber led @Harvard Health Services until 2011/2
Moloney, who became the champion of the 'pawn ball meg.' concept, came from @TuftsMedicalCtr & the old Boston City Hospital to become hematology chief at Peter Bent Brigham Hospital (now @BrighamWomens) in 1966. He continued to work until he turned 90 in 1997. @BrighamHeme /3
Tweetorial #5: the interesting origin of the CBL gene. This story will take us to Spanish California and the world of murine retroviruses⊠and C.P. âDustyâ #Rhoads of refractory anemia fame will even make a brief cameo appearance. This image is a ribbon diagram of CBL. #CBL /1
In the winter of 1812, a series of San Andreas earthquakes struck southern California, destroying the original church at San Juan Capistrano and damaging several other 'Las Californias' missions. There were also tsunamis, which would have made coastal living less appealing./2
After the earthquakes, a number of people living near the 9th Franciscan mission, "San Buenaventura", in present-day Ventura, California, withdrew from the immediate coast & temporarily moved inland to higher ground in another part of what is now Ventura County #VenturaCounty./3
Time for #hematology-#hematopathology-#history #tweetorial 4: the striking Pelger-Huët anomaly! These curious cells, sometimes mistaken for neutrophil bands, can be inherited; if acquired, they are often a sign of #MDS. I took this photomicrograph of a characteristic example./1
There have been a few histories of the Pelger-Huët anomaly published over the years; a particularly nice one was done by my friend @mrinal90151372 @MayoClinic and colleagues in the American Journal of Hematology 2009). The below Tweets include original research. #PelgerHuet /2
Karel Pelger (1885-1931) â often erroneously written âKarlâ in reviews - was born in the village of Nijeveen in rural Drenthe in the Netherlands. Though a country boy who disliked cities, he lived in Amsterdam because of his enthusiasm for science & better access to facilities./3
(Part 2 of the Refractory Anemia story.) The governor of Puerto Rico at the time, James Rumsey Beverly (1894-1967), ordered an immediate investigation of what he described as described as Rhoads' "confession of murder"./26
This inquiry, however, did not find any convincing evidence that Rhoads had actually intentionally harmed any patients. Rhoads was cleared of wrongdoing for his "parody" letter. The inquiry may have been a whitewash./27
Rhoads himself apologized to his laboratory personnel and claimed the letter had been a joke, but understandably, the Puerto Ricans did not find it particularly funny.../28
Since my recent "tweetorial" about the history of ring sideroblasts & Prussian blue seems to have been well received, I thought Iâd follow up with the fascinating and sordid history of the term, âRefractory Anemiaâ (RA). (This ugly #MDS image is from a book I edited years ago.)/1
The 1982 #FAB #MDS classification included chronic myelomonocytic leukemia (CMML), plus 4 categories with the term RA: 1) RA, 2) RARS (i.e., RA w/ ring sideroblasts), 3) RAEB (RA with excess blasts), and 4) RAEB-t (RAEB in transformation to #AML). But where did "RA" come from?/2
Iron salts had been used since the 17th century to treat âchlorosisâ â i.e., the green sickness, characterized by weakness and pallor. Thomas Sydenham (1624â1689) is usually given credit for first rational use. Here's a classic painting of a young woman fainting from chlorosis./3
There is an interesting history behind these cells, so familiar to hematologists & pathologists: ring (formerly 'ringed') sideroblasts. While most commonly associated with #MDS or inherited disorders like #XLSA, they can also result from ethanol or TB drugs - even hypothermia./1
Sideroblasts and siderocytes - red cells and their precursors with iron granules in the cytoplasm visualized by a chemical reaction - were first described by Hans GrĂŒneberg in 1942, a Jewish refugee from Germany working in London @ucl from 1933. /2
In 1955, Sven-Erik Björkman, working in Jan Gösta Waldenström's hematology unit @lunduniversity (thus far this tweetorial has 100% umlaut surnames!) noticed 4 of his anemic patients had weird sideroblasts: the iron granules encircled the nucleus. One of them developed leukemia./3
1/5 I believe I have seen the pre-future of civil society at the 2019-01-31 #micromobility conference #MMCA by @asymco @oliverbruce @James_Gross. I call it #Microurbanism
2/5 #Microurbanism is redesigning the infrastructure of cities to optimize physical, social, and economic mobility (HT #UBM @AlexRoy144) using the technology, data, and cycle times of #micromobility #MMCA
3/5 Real-time data on mobility and livability (HT #MDS @seletajewel) is the new newspaper: a common set of facts citizens can use to make informed decisions for the public good. #MMCA CC @remix @RideReportApp
My checkered history with NIH grant proposals: 1) First proposal was for a K award. Study section said I already had enough papers that I should instead apply for R award. Low agreement among reviewers evaluating the same NIH grant applications pnas.org/content/early/âŠ
2) So I applied for an R award the following year. Study section said I did not have enough of a track record yet and should have applied for a K award.
3) Then applied for correlative studies for a proposed trial. Study section said trial was unlikely to accrue. Trial did accrue, correlative studies were done with non-NIH funding.
