Discover and read the best of Twitter Threads about #amjgastro
Most recents (12)
1/13) #MedTwitter & has been an inspiring experience, however it can be 😳 at first
It was truly an honor to write this article in #AmJGastro alongside THE @AmyOxentenkoMD
👉 bit.ly/3a9k64r
Here is a brief #Tweetorial summarizing our paper, & some tips & tricks
It was truly an honor to write this article in #AmJGastro alongside THE @AmyOxentenkoMD
👉 bit.ly/3a9k64r
Here is a brief #Tweetorial summarizing our paper, & some tips & tricks
2/13) If you are new, 1st define your goals for #SoMe use
✅ Stay up to date w science
✅ Network & connect w colleagues / mentors
✅ Collaborations
✅ Career advancement
✅ Social networking
✅ Promote your practice, program or division/dept
You could have one or all of 👆
✅ Stay up to date w science
✅ Network & connect w colleagues / mentors
✅ Collaborations
✅ Career advancement
✅ Social networking
✅ Promote your practice, program or division/dept
You could have one or all of 👆
3/13) Set up your profile. Its the first impression on how others will 👀 you
➡️ Handle: Can be full name w degree (@AmyOxentenkoMD) or could be defined by your interests (@IBDMD)
➡️ Brief bio (role, interests, institution)
➡️ Don’t forget background pic - unused real estate
➡️ Handle: Can be full name w degree (@AmyOxentenkoMD) or could be defined by your interests (@IBDMD)
➡️ Brief bio (role, interests, institution)
➡️ Don’t forget background pic - unused real estate
Breaking data: Today we released a new study of 53K Americans revealing that use of proton pump inhibitors (eg. Prilosec, Prevacid, Nexium) is associated w/ a 2-4x risk of #COVID19. In this thread I explain why we did this study, what we found, what it may mean, & key limitations
2. Here is a link to the full peer-reviewed study published online in #AmJGastro: journals.lww.com/ajg/Documents/…. Also, the @AmCollegeGastro released this fact sheet with answers to FAQs: webfiles.gi.org/links/media/AC…. Both documents are more effective than tweets to convey the full results.
3. Let's start with biological plausibility. There's a reason we have stomach acid; it helps sterilize food by killing pathogens. We've known for years that acid can rapidly inactivate certain viruses. For example, this 2004 study shows pH<5 inactivates SARS-CoV-1.
Ammonia!
This test has such a big footprint in the landscape of liver disease management. But it is just too complicated to deserve its spotlight
Reposting this #tweetorial
NH3 levels:
1⃣a potent biomarker of illness
2⃣unreliable
3⃣only part of the HE story
#livertwitter
This test has such a big footprint in the landscape of liver disease management. But it is just too complicated to deserve its spotlight
Reposting this #tweetorial
NH3 levels:
1⃣a potent biomarker of illness
2⃣unreliable
3⃣only part of the HE story
#livertwitter
Since I posted this tweetorial:
1. ISHEN released a consensus, touching on NH3. pubmed.ncbi.nlm.nih.gov/32224704/?from…. This features the fig below
1. ISHEN released a consensus, touching on NH3. pubmed.ncbi.nlm.nih.gov/32224704/?from…. This features the fig below
2. A major publication on the variability and lability of Nh3 levels from @JasmohanBajaj @BloomPringle @AmCollegeGastro #amjgastro #livertwitter
ncbi.nlm.nih.gov/pmc/articles/P…
ncbi.nlm.nih.gov/pmc/articles/P…
CANNABIS & COVID-19
“TODAY in #AmJGastro:
48% of patients w. #COVID19 presented w. #GI symptoms first.
They did worse/had delayed admission (⬆️ community transmission?). Do we need broader testing criteria. #GITwitter remember to keep in mind when seeing new-onset GI symptoms”
“TODAY in #AmJGastro:
48% of patients w. #COVID19 presented w. #GI symptoms first.
They did worse/had delayed admission (⬆️ community transmission?). Do we need broader testing criteria. #GITwitter remember to keep in mind when seeing new-onset GI symptoms”
Dr. Badgley, M.D. Response:
GI SYMPTOMS IN COVID-19 INFECTION: the described symptoms suggest that parasympathetic dysautonomia might be result of the coronavirus pathophysiology.
GI SYMPTOMS IN COVID-19 INFECTION: the described symptoms suggest that parasympathetic dysautonomia might be result of the coronavirus pathophysiology.
Anosmia and headache are also reported as common premonitory symptoms, and these bespeak of central neurological dysfunction; perhaps at brainstem level.
🌶 don’t just do something, stand there!
Are we going to act on the mounting data that antibiotics may not improve outcomes in uncomplicated diverticulitis?
No diff in LOS in RCT of abx
Pmid: 32240832
@AGA_CGH
(See inclusion criteria)
Are we going to act on the mounting data that antibiotics may not improve outcomes in uncomplicated diverticulitis?
No diff in LOS in RCT of abx
Pmid: 32240832
@AGA_CGH
(See inclusion criteria)
🌶🌶🌶
Tired: sarcopenia
Wired: frailty/function
Pretransplant Gait speed predicted postop lung complications better sarcopenia
Limits: small pop of LDLT patients and an outcome that I am sure wasn’t their first choice! 😉
#AmJGastro #cirrhosis
Tired: sarcopenia
Wired: frailty/function
Pretransplant Gait speed predicted postop lung complications better sarcopenia
Limits: small pop of LDLT patients and an outcome that I am sure wasn’t their first choice! 😉
#AmJGastro #cirrhosis
Today I would like to read and tweet about non-#covid things
Will start a string of pearls and 🔥🌶takes from recent papers #livertwitter #gitwitter #cirrhosis
Will start a string of pearls and 🔥🌶takes from recent papers #livertwitter #gitwitter #cirrhosis
This paper in #amjgastro compared refeeding @ 24 v48 hrs after endoscopic interventions for peptic ulcers. 24 hours was “not noninferior”. multiple limits
1️⃣ ⬆️mortality in 48h
2️⃣diff duration of iv ppi
My 🌶🌶 take: feed your patients when they want!
1️⃣ ⬆️mortality in 48h
2️⃣diff duration of iv ppi
My 🌶🌶 take: feed your patients when they want!
Evolving #COVID19 data, please share: Could COVID19 spread through stool? In this thread, I will summarize what our editorial team at #AmJGastro knows about the risk of fecal spread. I will start by emphasizing that we do *not* yet know, for sure, if it spreads though... (1/10)
...stool. But we do know the following: (1) #COVID19 genetic material is frequently found in stool. This study found 53% of stool samples were positive: gastrojournal.org/article/S0016-…. (2) The virus sheds into the stool for weeks, even after respiratory symptoms subside. This... (2/10)
...report found that for >50% of patients, fecal samples remain positive for ~11 days after respiratory samples are negative: thelancet.com/journals/langa…. The authors suggests the virus replicates in the GI tract even after viral clearance in the lungs. (3) The virus can be... (3/10)
Breaking #COVID19 Data – Please Share (1/10): On behalf of @AmCollegeGastro, our editorial team at #AmJGastro just released a study from Wuhan, China reporting 48.5% of patients presented to hospital with a digestive symptom as their chief complaint. Coronavirus is #NotJustCough.
(2/10) One in 5 presented with either diarrhea, nausea, vomiting or belly pain as the presenting complaint. “Clinicians must bear in mind,” write the authors, “that digestive symptoms, such as diarrhea, may be a presenting feature of #COVID-19, & that the index of suspicion may…
(3/10) …need to be raised earlier in these cases rather than waiting for respiratory symptoms to emerge.” Moreover, patients with digestive symptoms had a worse clinical outcome and higher mortality. Emphasizes importance of including symptoms like diarrhea to suspect #COVID19.
The face of #Cirrhosis is changing.
Why and what does it mean (for patients, not just providers)
Jad (@jadbaki_) Baki and I had to opportunity to write about it for @JasmohanBajaj's section at current treatment options in gastro
Open access: rdcu.be/buOnD
Why and what does it mean (for patients, not just providers)
Jad (@jadbaki_) Baki and I had to opportunity to write about it for @JasmohanBajaj's section at current treatment options in gastro
Open access: rdcu.be/buOnD
Want 2 call out 3 🔑 #cirrhosis epi papers
- Flemming:😱stats re: cirrhosis in youth thelancet.com/pdfs/journals/… @LancetGastroHep
- Asrani: hospitalization risk: insights.ovid.com/pubmed?pmid=30… #AmJGastro
- Mellinger on incidence/cost of ETOH-cirrhosis @HEP_Journal aasldpubs.onlinelibrary.wiley.com/doi/full/10.10…
- Flemming:😱stats re: cirrhosis in youth thelancet.com/pdfs/journals/… @LancetGastroHep
- Asrani: hospitalization risk: insights.ovid.com/pubmed?pmid=30… #AmJGastro
- Mellinger on incidence/cost of ETOH-cirrhosis @HEP_Journal aasldpubs.onlinelibrary.wiley.com/doi/full/10.10…
What do you think @AndrewMMoon? I think this topic needs a deep dive on the data - a comprehensive document that summarizes where we stand, the gaps in the field, and what we can do to improve our knowledge of the burden of chronic liver disease in these changing times. AmIright?
Hepatic encephalopathy in the hospital (An ode to #lactulose):
A brief #livertwitter #tweetorial
Aims:
1. Share the greatest t-shirt ever made
2. Rule out infection!
3. Laxation now! But how?
keywords: #cirrhosis, paracentesis, stool pH
A brief #livertwitter #tweetorial
Aims:
1. Share the greatest t-shirt ever made
2. Rule out infection!
3. Laxation now! But how?
keywords: #cirrhosis, paracentesis, stool pH
1. This shirt, made by a patient, reminds us:
▶️HE is horrible, unpredictable
▶️Preventing HE is hard
▶️Dont be quick 2 label pts as 'noncompliant' - there's more to the story
▶️Our patients are awesome. Hepatology is the best
#lactuloseorcomatose
▶️HE is horrible, unpredictable
▶️Preventing HE is hard
▶️Dont be quick 2 label pts as 'noncompliant' - there's more to the story
▶️Our patients are awesome. Hepatology is the best
#lactuloseorcomatose
2. Think of hepatic encephalopathy as a biomarker.
For what? The answers form a mandatory checklist of sorts
1. Para to r/o SBP. Delay @ your patient's peril. (Fig1)
2. GI Bleeding?
3. UA/Blood Cultures/CXR
3. What's the Cr? Na? K?
review: nature.com/articles/s4139…
#AmJGastro
For what? The answers form a mandatory checklist of sorts
1. Para to r/o SBP. Delay @ your patient's peril. (Fig1)
2. GI Bleeding?
3. UA/Blood Cultures/CXR
3. What's the Cr? Na? K?
review: nature.com/articles/s4139…
#AmJGastro
A celebration of paracentesis: a QI #Tweetorial
For all my twitter friends who care for inpatients with #cirrhosis
Take home messages: paras for all, FFP for none
Keywords: #SBP and the #cirrhotic #coagulopathy
For all my twitter friends who care for inpatients with #cirrhosis
Take home messages: paras for all, FFP for none
Keywords: #SBP and the #cirrhotic #coagulopathy
First - which hospitalized patient needs a diagnostic para?
Patients with ascites and:
Patients with ascites and:
Spontaneous bacterial peritonitis (SBP) is a deadly condition. Appropriate tx can prevent hepatorenal syndrome and death.
How many patients are asymptomatic?
Many.
In this study from Pinzello et al, 1 in 3 patients with SBP were "silent"
aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.10…
How many patients are asymptomatic?
Many.
In this study from Pinzello et al, 1 in 3 patients with SBP were "silent"
aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.10…
#ChiefResident blog #NoonConference #meded Statin-induced rhabdomylosis in a patient with Liver Disease imrespdx.com/imrespdx-blog/…
Check out this @bmj_latest article re risk factors for statin-related complications #NoonConference #meded bmj.com/bmj/section-pd…
while liver disease is RF for statin myopathy, a 2017 @AmCollegeGastro #AmJGastro systematic review/meta-analysis suggests statin use may slow progression of hepatic fibrosis, prevent hepatic decomp, and reduce mortality in pts w chronic liver dz nature.com/articles/ajg20…
