Discover and read the best of Twitter Threads about #PHODocs
Most recents (8)
Dr. Mark Fleming talking about pathology vs molecular testing in MDS. He first reminds us the difference of childhood MDS from adult MDS -- and these WHO guidelines, childhood MDS is only classified into these two subtypes. #ASH22 1/n 
The issue is that the "dysplasia" definition has been defined by the cytogenetic abnormalities and genotypes of adult MDS so the criteria for blast %age, extent of dysplasia -- but does this apply?? #ASH22 2/n
MDS in pediatric patients is more normo or hypocellular than hypercellular. There is not ringed sideroblasts in persons <30 and he also reminds us that there are a number of baseline dysplasias in germline BMF pts that are mistaken for MDS! #ASH22 3/n
#ASH22 Bone marrow failure syndromes: diagnostic principles in 2022. Starting with Sara Lewis, a genetic counselor in hematology. Follow this tweet for more. 1/n
Sara reminds us that she feels patients think more about their family history as they see her draw the pedigree. Time for me to start doing this! #phodocs #ASH22 #pearl 2/n
Here are the options for diagnostic workup - genetic tests can be done from somatic genes or germline! #ASH22 3/n
@SharonSavageMD presenting on #DyskeratosisCongenita #DC update. Starting a pt presentation with a de novo TINF2 variant. #ASH22 1/n
@SharonSavageMD She mentions her GI bleeding (as well as other findings) -- something I have seen in #DC. What we know - females do better than male (due to X-linked disease) #ASH22 2/n
@SharonSavageMD Squamous cell carcinoma and AML and MDS rates are high as we know in all these bone marrow failures -- and transplant accelerates this. #ASH22 3/n
When to think about Fanconi anemia? Remember that genetic testing may be difficult to interpret and can be inconclusive - so correlation with clinical/functional studies is required. #ASH22 2/n
Extra hematologic assessment is required -- look how many places to check outside of the CBC in these patients. Think about Moya moya in your Fanconi anemia patients and take off your patient's mask and check their oral cavity for squam/mucosal cancers. #ASH22 3/n
Management of iron overload for #phodocs to pay attention to. Talk by Dr. Lalefar from @UCSFBenioffOAK. Follow this thread 1/n
Who should be monitored for iron overload? Those that have a transfused volume >100 ml/kg (~10 transfusions) #ASPHO2021 2/n
Dr. Lalefar suggests checking ferritin, but remember to check with other iron studies. She says a serum ferritin >1000 ug/L is the common threshold used. (But this was based on correlation studies with liver iron from mostly Caucasian hemochromatosis patients) 3/n
Snapshot of current #phodocs peds data on doac studies. Rivaroxaban (einstein jr) and Dabigatran completed.. data to follow in this thread #ASPHO2021 1/n
Prelim data from rivaroxaban showed <12 kg patients needed TID dosing. The phase 3 dosing is given here. Phase 3 data showed decreased rate of VTE and no major bleeding. 2/n
Dabigatran (DIVERSITY) data was published Jan 2021 phase 2b/3 non-inferiority trial. They used composite primary endpoint of complete resolution, freedom from recurrent VTE and VTE-related death. 3/n
Will tweet some pearls from @Sisk_MD's (young investigator award winner) plenary talk on communication breakdown in #pediatriconcology #phodocs here at #ASPHO2021 1/n
Communication has lots of functions -- not just passing information. @Sisk_MD outlines 8 here. 2/n
He did qualitative research with a total of 80 parents of children with cancer across different time points and different ages. ... 95% of parents experienced negative communication experiences! (with everyone - ALL team members) 3/n
As a pediatrician & bioethicist, I find myself thinking a lot about the effects of #COVID19 on children, both currently and & in the future. These effects appear to influence nearly all aspects of kids' lives: their health, families, education, & everything between
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Early on in the pandemic, it appeared that children (for reasons that still are not totally clear) were less susceptible to the severe sequelae of #COVID19
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Data are still emerging, but recent work supports these early reports. Severe illness in children can be significant but occurs far less frequently than in adults, as reported via a large international collaboration in @JAMAPediatrics:
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