Discover and read the best of Twitter Threads about #Pediatrics

Most recents (24)

HEPATITIS AGUDA INFANTIL de origen desconocido

¿Realmente la está causando el #Adenovirus F41? 🧐

Hay algunos puntos a considerar. Va mi opinión al respecto🧵👇🏼

1/15

#HepatitisAgudaInfantil
Hace un mes (15Abr22) nos enteramos de que Reino Unido 🇬🇧 estaba reportando un incremento inusual en los casos de #hepatitis de origen desconocido en pacientes pediátricos, especialmente en l@s más jóvenes

Después otros países empezaron a reportar lo mismo (tot: 169 casos)

2/15
La presentación clínica, es decir, la manera en la que el personal médico identifica la enfermedad👩🏻‍⚕️, es una #HepatitisAguda (el surgimiento rápido de inflamación en el hígado) con una elevación muy pronunciada 📈 en los niveles de proteínas provenientes de ese órgano¹

3/15
Read 16 tweets
🧒🩸 Let Your Love Flow 🩸🧒

"When we look at Covid infections the spike protein part of the virus... it causes enormous amounts of clotting.
It can directly infect the myocardium and the vascular endothelium, the cells within the vessels. @ 29:28>
podcastaddict.com/episode/135012…
We know IN AND OF ITSELF it can cause certain things.
IF WE'RE GONNA USE A 💉 TO STOP THAT, WE DON'T WANT THE 💉 to do the same thing.
And that's what we're seeing with the RNA/DNA💉utilizing the spike protein. Our concern, as we started looking at people, it initially started>
started out as 1 in 50,000 chance of someone who had gotten the💉that they would get myocarditis. But then as, more and more people got it, we started looking a bit more closely. There was the study that looked at Big 12 athletes, they didn't tell us whether they were💉or not.>
Read 9 tweets
An in-depth review of Slipped Capital Femoral Epiphysis (SCFE).

If you're interested in orthopedics or pediatrics you'll definitely want to check this review out!

1/ Image
SCFE’s are an adolescent hip pathology with an average age of onset of 11-12.

The diagnosis may be initially missed because the patient may present with thigh or knee pain.
Risk factors include:
✯ Obesity
✯ Male gender
✯ Prior radiation
✯ Endocrine abnormalities
✯ Certain ethnicities (e.g. African American)

Obesity is one of the most important and modifiable risk factors.
Read 12 tweets
Had an opportunity to visit few #MTIs in #KPK with the purpose to explore #PedsICU infrastructure & need assessment and collaboration for capacity building. 1/12
Overall basic infrastructure is there and the need is unmet. And there is a desire on ground to build this field of #Pediatrics which is encouraging. The management is excellent and there is an #EHR in place. All these make an excellent starting point. 2/12
We need to keep few facts in mind while embarking on this challenging and but truly rewarding journey of providing quality acute hospital care to #children in #KPK & #Pakistan 3/12
Read 13 tweets
Thing is… even prior to #COVID19, it was known that viral shedding can occur in feces up to 3 weeks or longer. Isolation periods have always been subjective. That said, for airborne spread, there is a need to take precautions while infectious in that way #Omicron
Specific to #COVID19 (in #Pediatrics)

“duration of viral shedding in infected pediatric patients. Virus was detectable for a mean (SD) of 17.6 (6.7) days overall and was detectable for a prolonged period of time in all cohorts of children”

jamanetwork.com/journals/jamap…
Then this.

“Duration of symptoms ranged from 1 to 36 days. Positive tests were recorded up to a median of day 21 (range 6-38).”

pubmed.ncbi.nlm.nih.gov/33911876/
Read 8 tweets
This makes me so 🤢

The idea that women are automatically “safe” is exactly what creates this “opportunity” for some women to exploit children & monetize their “optics” of “trustworthy” on behalf of predators.

Gender does not predict ethics, integrity, safety.
Why does #GhislaineMaxwellTrial matter to #womeninSTEM?
⬇️federal funding
➡️private donors (Epstein)

“Socialites” open doors to elite spaces, including #academia #science #STEM
Women=“optics” & “reputation management” for these wealthy predator men

theverge.com/2019/9/19/2087…
These same connected women, often daughters of powerful businessmen

are on boards of #WomeninSTEM “empowerment” organizations or on #MeToo (TimesUp scandal)

the very women who are predators of young women are given access to women’s “safe spaces”? (!!!)

bustle.com/entertainment/…
Read 33 tweets
#antivaxx efforts now even use #deepfake

to target #refugee, Black, religious minority communities

like measles outbreak in Minnesota in 2019: Wakefield was flown in TO spread #misinformation & #disinformation

Now: online fake accounts/fake identities vs #VaccinesWork
What has #healthcare been doing meanwhile?

#Medbikini: Teach (male Asian) med students to make fake accounts to cyberstalk trainees’ personal Facebook for: bikini
or “being political” or “religious” (#BLM)

➡️“model minority” pipeline for “shadow faculty” vs Blck @ayshakhoury
#Medbikini #research got flak for men vs women

BUT was ALSO fake acct #surveillance vs #BLM like drove out @ayshakhoury @uche_blackstock @nhannahjones

While academia has ignored #vaccineequity
➡️ongoing #pandemic & deaths in marginalized targeted by #antivaxx

@womanistpsych
Read 23 tweets
This 👇🏽👇🏿👇🏻 This is why #BLM exists & why “implicit bias” is not only real but it kills

Why, when you see it, say something, do something
The system changes not by sharing tweets & hashtags but actions & consequences & removal of toxicity from the system

Follow #BlackTwitter
Above #MedEd #TikTok improvement: #citeblackwomen who lead this work (not only utilized the savior mindset of Black & brown as victims) #Blackexcellence @citeblackwomen center Black women
Send #SoMe traffic to Black creators & activists. #healthcare twitter.com/i/lists/122380…
Take #sharethemic initiative. It allowed #Blackexcellence to speak thru #influencer accounts to large followings for a day. I looked at before/after numbers, it did NOT drive any additional traffic to the actual accounts of those voices. Resurfacing this:

https://t.co/VZ26WWNxRP
Read 45 tweets
1/ With #Vaccines approved for 👧🏽👦🏾 5-11 yo parents have a decision to make. #Omicron reminds us we aren’t through this yet.

As a #Pediatrician I have spent my career helping parents make health care decisions about their kids. This🧵is about #risk and the decision to #Vaccinate
2/ The decision to #Vaccinate means you believe the benefit outweighs the risk - so let’s break it down starting with- what #risk does #Covid19 pose to our #kids?
3/ Acute risk in 5-11 yo from 🇨🇦 data:

Hospitalizations 🏥 in 0.2%
Death in 0.002%
#LongCovid in 2-5% (still learning)
#MIS-C 1/3500 cases (most common in 5-11 age group)

Let’s remember kids rarely die so this is on par with other diseases we prevent with #vaccination
Read 8 tweets
A thread of some useful & reliable resources on #COVID19 & #CovidVaccines 🧵⤵️

(I know it can be a challenge to stay up to date with lots of new information & questions! As I am currently "studying" for a Facebook Live tomorrow...)
Lots of expert-reviewed shareable content on vaccines, science literacy, public health, etc! @ScienceUpFirst scienceupfirst.com/share/
Really like the easy-to-understand infographics from Sabina Vohra-Miller via Unambiguous Science @SabiVM
unambiguous-science.com/infographics/
Read 15 tweets
I’m curious to know how pediatricians feel about off-label use of the COVID-19 vax for 2-4 year-olds once 5-11 year olds become eligible

Say FDA issues an EUA for 5-11 year olds this month: should off-label use for younger kids be allowed?

#MedTwitter #Tweetatrician #Pediatrics
Folks reacting to this that are not pediatricians:
🔸Off-label use in pediatrics is quite common, but not with vaccines
🔸Off-label usage would *allow* but not *require* parents of younger kids to get them vaccinated
🔸Work toward an FDA EUA is ongoing, this doesn’t change that
Hearing from some Pediatricians via QTs and DMs: so far, the “nays” have it. Specific reasons center around wanting to see the data for 5-11 year olds.

IOW: it’s premature to consider this hypothetical
Read 5 tweets
#LongCOVID

We reviewed 14 studies of persisting symptoms following #COVID19 in #children & #adolescents

Most had major limitations and should be interpreted with caution.

True risk is likely to be nearer 1 in 100 than often quoted 1 in 7.

#medpeds #IDTwitter

(Long) 🧵1/n
The 14 studies involved 19,426 children & adolescents.

Common persistent symptoms reported 4-12 weeks after acute #COVID19 were:

•headache
•fatigue
•sleep disturbance
•concentration difficulties
•abdominal pain.

Symptoms rarely lasted more than 12 weeks.
Read 13 tweets
I keep seeing hot takes on how covid affects kids + if it’s dangerous for them.

But amazingly there’s still a striking shortage of pediatrician voices given the opportunity to provide our nuanced and expert opinion.

What would we say if you asked us?

A thread 🧵
Pediatricians have a lot to say about the covid in kids, how to balance the risks and benefits of exposure, and how to make personal + public health decisions that prioritize the needs of children.

What would we say if asked how dangerous covid is for kids?
We’d ditch glib mortality statistics that dress up data as science + paint a more complicated picture.

We’d reassure you that children continue to mostly do well with acute covid. We’d then explain that deaths + hospitalization from acute covid are just part of the equation.
Read 15 tweets
Team it's time to address the Hoeg et al preprint on post-COVID vaccine myocarditis. How am I qualified to speak about myocarditis? I am board certified in paediatric cardiology and currently have patients recovering from this condition. TLDR: They are doing quite well. #MRI
What is the premise of that article? directly scanning VAERS data will result in capturing more cases of myocarditis, and therefore the "conclusion" that COVID vaccine generates a higher risk of myocarditis than COVID disease. But - cardiologists have diagnostic criteria. #heart
All that bleeds troponin is **not** myocarditis. I cite my professional society, the American College of Cardiology: #myocarditis #COVID19 #vaccination #VaccinesWork Image
Read 18 tweets
To reassure parents, a reminder of some key facts about #COVID in #children:
 
#SARSCoV2 infection remains asymptomatic or mild in the vast majority of children, even with the #DeltaVariant. Hospitalisation and deaths from COVID are still rare in this age group.

1/n 🧵
However, the greater transmissibility of the Delta variant means there is more COVID in *all* age groups, including children, so we will see more paediatric cases.
As a large number of older people are now vaccinated, the increase is blunted in the elderly so, compared with earlier in the pandemic, a higher *proportion* of current cases will be in children: this can give the mistaken impression that the Delta variant is targeting children.
Read 7 tweets
Within past few days the American Academy of #Pediatrics has quietly removed its "#Face Time & #Emotional #Health" info sheet (PDF) for parents w/ new infants.

It can still be found in web archives:

web.archive.org/web/2021081110…

[h/t @Bleedinheart2MD, @tapuaetai_l, @galexybrane]
American Academy of Pediatrics (AAP) & AAP Friends of Children Fund, partners & corporate donors:

Johnson & Johnson
Seqirus
Sanofi
Sobi
Nestlé
Abbott
Genentech (Roche)
Merck
GlaxoSmithKline
Kaléo
Novo Nordisk
Supernus

More👇

#4IR #Biotech #EmergingMarkets #SDGs
Do you see it yet?

With each passing day, children are being conditioned to endure a #4IR global architecture. The restructuring of the global economy. A societal transformation, global in scale.

"Who will thrive, who will perish?" (Deloitte)

#Digital transformation.
Read 4 tweets
I’m a Pediatrician = ❤️👶🏽🧑🏻👩🏾. I have worked in Children’s Hospitals, on medivac teams and now in the North. These are my thoughts on what we are facing with #Delta going into the fall
1. Wave 4 of #COVID will be a pandemic of #misinformation, under-vaccination and inadequate mitigating public health interventions (removing mask mandate, not addressing school ventilation, etc). We have reached the limits of what “encouraging people to get vaccinated” can do.
2. Who will pay the price? #Children, esp children < 12 who can’t be #VaxXed. It is misleading to say “not that many kids die”. #Mortality is a pretty crude outcome measure in #Pediatrics. What about disability, medical trauma, impact on families, mental health?
Read 8 tweets
New preprint 🧵🧵🧵: bit.ly/3zH0IYr
Led by @ SaahithiRao @MattKellyMD and @Duke_Childrens @DukeCHDI colleagues Wen Zhao, Jason Lang, Laine Thomas, and Ben Goldstein
#asthma #pediatrics #SARSCoV2
Remember how in #DukeBRAVEKids we found that kids with asthma seemed to be at lower risk of SARS-CoV-2 infection?
bit.ly/3x4F7ah
We decided to try to run that down using a population-level, retrospective EHR-based analysis from @DukeHealth
We identified every kid in the system (6,515) who met our asthma definition started (bit.ly/2V8DDPj), lived in Duke’s main catchment area, and had at least one encounter in the two years before the pandemic
Read 25 tweets
Multisystem inflammatory syndrome in children is driven by zonulin-dependent loss of gut mucosal barrier.. @vipintukur @ProfSomashekhar @naveenthacker @iapindia @INDIANJOURNALO4 @VirusesImmunity @EditorIndPed @ICMRDELHI @MoHFW_INDIA @iiscbangalore Image
Weeks after #SARS-CoV-2 inf or exposure, some children develop a severe, life-threatening illness called Multisystem Inflammatory Syndrome in Children (#MIS-C). GI symptoms are common in MIS-C pts & severe hyperinflammatory response ensues with potential for ❤️ complications.
👉🏽As proof of concept, they treated a #MIS-C patient with #larazotide, a #zonulin antagonist, & monitored impact on antigenemia and clinical response.
👉🏽in MIS-C, prolonged + of SARS-CoV-2 in t GI tract ➡️ to release of zonulin, a biomarker of intestinal permeability,
Read 14 tweets
Delighted to report our paper examining the ‘missing’ children from hospitals during the first COVID-19 UK lockdown has just been published in @EurJPediatrics
rdcu.be/clnF6
Explanatory thread below:
1/ We were interested in discovering which children were ‘missing’ from hospital services as the first lockdown started. We analysed anonymised records of patients <16yrs in 2 Oxfordshire (UK) hospitals, providing secondary & tertiary care.
2/ We looked across 6 years: in 2020 prior to, during and after lockdown & 2015-2019 across matched dates including the same number of weekdays/weekends. ICD10 codes gave us the diagnoses of inpatients across all 6 years to assess ‘missing’ diagnoses during lockdown.
Read 20 tweets
Word “racism” silenced, actively, by #MedEd #MedTwitter #healthcare#professionalism” & “communication” labels

Saying “racism” offends or “hurts feelings” > actual #BLM deaths

If #professionalism itself is racist -makes sense that word suppressed
@FutureDocs
What @ayshakhoury experienced pushes out & silences many

If the editors of @JAMA_current resist hearing word “structural racism” then they certainly are not publishing papers using that word

@DrAlethaMaybank @RheaBoydMD @FutureDocs @TIME #BlackintheIvory #MedTwitter @bmj_latest
Journal gatekeeping: men
Behavior gatekeeping: women/HR

#accountability only for white men
-> we miss “Amy Cooper” in #academia, #HR, #professionalism #compliance

insidehighered.com/advice/2020/06…

@DrAlethaMaybank @RheaBoydMD @FutureDocs @TIME #BlackintheIvory #MedTwitter @bmj_latest
Read 18 tweets
In light of the Boston police Union leader child abuse, this is very plausible, even probable. I have 2x, on behalf of someone else, reported, via Title IX - the woman or gay man was not feeling safe enuf to report. Yes, there is blowback when one reports. But we can’t be silent.
I am a mandated reporter as a #pediatrician. I *must* report for my patients or face legal consequences. Am same for staff, students, trainees. But in #EmergencyMedicine who do I call if a child may be unsafe at home? Sometimes, cops. Are cops safe?

boston.com/news/local-new…
I have seen #mentalhealth and entire life paths destroyed by abusers preying on children like: This happened to too many people I know. I have seen institutions intimidate, mislabel, bury stories of the victims. (Some predators wait until 18th birthday.)

nytimes.com/2017/08/07/nyr…
Read 29 tweets
This is why I do long threads on racism in child & education spaces (child education up to #MedEd) and on the role of women to “protect” only some kids, not others. There is focus on police without looking at the full picture of sources of harm to children of color.
It is very very easy to focus on the Boston police Union leader

but who is it that..

helps him get access to children?
stays silent?
silences abused children?
promotes him?
seeks to please him (be promoted by him)?
sees him as a “good leader”?
softens his image?
protects him?
The role of men & women who police/silence those who would speak up... who prevent identifying the abuser

=extremely important

it is all on one spectrum: if you experience being denied food by a teacher as a 3-year old, will you speak up on abuse...

vs Stockholm Syndrome?
Read 7 tweets
I state, highlight, mark up, not insinuate
Why is someone who likely does not menstruate a sudden expert on #womenshealth to identify a WOC seeking #data #quality & #integrity as the threat...to women?
"Respecting" social science = using respectable methods, not online surveys.
What you see in the tweet and the "study" is ego, defensiveness & flagrant Dunning-Kruger effect for #womenshealth, #menstrualhealth, #COVID19, #vaccine #research.

The best way to demonstrate the value of a field is to be consistent on #quality not

sciencedirect.com/science/articl…
Academic language on #online #survey #data:
"systematically assess carelessness in a crowdsourced sample" Denial that quick & dirty is poor #quality is an odd use of time & ineffective. One could better defend one's merit, by delivering #quality per best practices and standards.
Read 35 tweets

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