Discover and read the best of Twitter Threads about #diagnosis

Most recents (24)

Finally, the #GoldacreReview is published! (During Parliamentary Easter holidays, mid-ping-pong on the #HealthAndCareBill...)

It's 221 pages - each PDF page is a double page spread - so this could be a lo-o-o-ong [Thread].

Here goes...
First point to note, in the Terms of Reference (p5), is that this is about "access to #NHSdata by #researchers, #commissioners, and #innovators" - i.e. #Planning and #CommercialReUse - so it is directly relevant to the operation of millions of people's #NationalDataOptOuts... Terms of reference for the review  1. How do we facilitate a
"185 wide-ranging recommendations for us to explore", says @sajidjavid (p6). Gulp! Time for some coffee...

"systems that ensure #underrepresented groups are well represented" may (partly) refer to this "landmark review", which got off to a slow start:

gov.uk/government/new… The far-reaching independent review into potential ethnic bi
Read 159 tweets
Today @GeneticAll_UK is launching a new report, ‘Good Diagnosis:Improving the experiences of #diagnosis for people living with rare conditions’.

Read the full report geneticalliance.org.uk/gauk-news/news…
#GeneticAllianceUK
#RareDiseaseDay2022
#RareDiseaseDay
Over a third of people living with a #RareCondition
will wait for more than five years to obtain a
definitive #diagnosis, often receiving a number of
#misdiagnoses along the way

#RareDiseaseDay2022
#RareDiseaseDay
The ‘diagnostic odyssey’ is a term used to describe the time taken between a patient first developing #symptoms and receiving a correct #MedicalDiagnosis. This can be a long and eventful journey.

#RareDiseaseDay2022
#RareDiseaseDay
Read 53 tweets
Brainstorming - this probably won't makes sense.

Why categories are better than dimensions for personality disorder classification: dimensional traits are unitary constructs, sub-factors, or unique facets. Categories are multi-factorial. People are not simply entities

1/
consisting of different amounts of a set of facets. They are complex, dynamic, and motivated beings wherein beliefs, desires, and actions don't always align. Ambivalence often reigns supreme. Behavior is multiply determined and their personality is best understood in terms

2/
of theoretically coherent interrelated domains such as motivation and interpersonal style; wherein content defines the domains; rather than the domains themselves being identical to the content.

3/3

#PersonalityDisorders #Diagnosis #Classification #DimensionalModels #Categories
Read 6 tweets
Write this down: “The purpose of daily rounds & presentation (& progress note) is to *document the behavior of the disease under observation and treatment*.” This is the paramount philosophical purpose. You can include superfluous and redundant boilerplate (eg RRR no MGR no CCE)
But your presentation MUST contain all the data from the patient/exam/labs etc which allow an assessment (explicit or intuitive) of whether the patient is getting better or worse or not progressing, whether the expected is happening or not, & whether there r unexpected findings
Ideally, these rspecific to the pt & the disease rather than routine claptrap; if your patient has #complicatedPPE, the output of the chest tube will have a central position in the presentation; if it’s asthma, wheezing, RR, acc mm use. Tailor ur assessment to the disease….
Read 5 tweets
This 30ish woman of mean height has a recurrent right spontaneous #PTX 18 months after the first. She has a history of thoracic pain receiving spinal steroid injections; o/w healthy. The best way to get the #diagnosis is (poll next) Image
The best way to get the diagnosis is:
Read 12 tweets
#WeekendLecture
Intracranial Atherosclerotic Disease #ICAD

#ICAD leads to changes ranging from minor wall thickening to #hemodynamically significant luminal stenosis and is one of the most #common causes of #stroke worldwide
ahajournals.org/doi/10.1161/CI…

🧵 Image
#WeekendLecture
#ICAD

✅10% of stroke, based on autopsy studies
bit.ly/3v6Lhrd
✅More prevalent in #African Americans, #Hispanics, and #Asians as compared with whites
bit.ly/3AuSiDt

Other risk factors in table Image
#WeekendLecture
#ICAD

In postmortem studies
👉degree of luminal #stenosis
👉% of the plaques containing >40% #lipid area
👉prevalence of intraplaque #hemorrhage, #neovasculature and #thrombus,
were higher in those #plaques associated with #infarct
🔹karger.com/Article/Abstra… Image
Read 13 tweets
A #thread about coming to terms with the past after a late autism diagnosis.

I discovered I was autistic at 58, so I had a lot of past to come to terms with.

Although the autism assessment was thorough, it barely scratched the surface.

#AllAutistics
#ActuallyAutistic

1/
What had happened to me was touched on only to the extent that was necessary to provide evidence of #autism.

So when I got my #diagnosis things had been revealed to me but not worked through, or dealt with.

That helps to explain why I’ve spent the last 2.5 years in turmoil.

2/
When you get your autism diagnosis no one lifts all the responsibilities of daily life from you.

So there I was, burnt out, traumatised, and confused, still trying to earn a living, care for others, and cope with my own long term physical and mental health conditions.
#cptsd
3/
Read 25 tweets
How good are doctors at diagnosis?

This is the most relevant paper I have written. Not perfect but addresses a huge issue I think could change medicine if acknowledged
…it has changed how I think about diagnosis

ja.ma/3rQNtjv
@JAMAInternalMed
@drjohnm
1/n
summary:
Clinicians widely overestimated chance of disease especially after testing

Cardiac ischemia after + ECG—EBM 2-11%, median answer 70%
UTI after + urine cx—EBM 0-8.3%, answer 80%
Breast CA after + mammo—EBM 3-9%, answer 50%
Pneumonia after + CXR EBM 46-65%, answer 95%
Gerd Gigerenzer, David Eddy, @StevenWoloshin @arjunmanrai & others asked how well doctors do at the math of understanding diagnosis, and found they aren’t great.

Many of issues w/ real life tests covered by @deeksj @d_spiegel @dan_diekema
Read 20 tweets
#Thread

Getting my autism diagnosis very late in life - what happened next.

A personal autistic perspective on #LateDiagnosis

#AutMentalHealth
#ActuallyAutistic
#MentalHealth
#AllAutistics
#autism
#cptsd

1/
It felt a like a fairy tale to begin with.

I’d reached the transformation scene.

My struggle to make sense of my life was over.

I wasn’t flawed, I was autistic.

But I was nearly 59 years old.

And I’d suffered a lot of harm.

#autism
#ageing
#autistic
#diagnosis

2/
My initial reaction was relief, followed by sadness and regret about things that had happened during my lost years.

And there was a tinge of anger, because I’d asked for help repeatedly, but no one ever considered that I might be autistic.

Time to move on.

3/
Read 20 tweets
When we rest we often feel guilty. Society values effort, productivity and achievement above everything. But for me resting isn’t doing nothing, it’s an essential part of preparing to do something, and recovering afterwards. It’s how I survive.
#AllAutistics
#burnout
#autism
1/ Picasso’s painting ‘Rest’ - abstract image of face res
At nursery #school #rest was factored in. We napped on camp beds with scratchy blankets after lunch. Even at primary school we were given the opportunity to lay our heads on our hands on our wooden desks while the teacher read to us. Short interludes in otherwise hectic days.
2/ Black and white photo of children sitting at wooden school d
The thing I remember most about secondary school is rushing. We were always hurrying from one place to another, at risk of being late, but not allowed to run. My only restful moments were in the art room, library and garden, or walking up to the playing fields to do sports.
3/
Read 20 tweets
This Summer I wrote a paper on ADHD comorbid w/AUD. This article mentions that #addiction is more common in those with ADHD. BUT it’s only more common if the ADHD goes un-dx, causing greater chances of “risky behaviors” early-on, leading to addictions.

thespicytherapist.com/how-to-stop-wa…
I felt it important to discuss this so we don’t reinforce stereotypes. While addiction can be common in those with #ADHD - it is, sadly, much more common when DX/treatment wasn’t given early-on or if never a dx/treatment was never given. #adhdtwitter #ADHDers
The reasoning for this is that in adolescence those with un-dx ADHD are have an increased chance of engaging in “risky behaviors” earlier- leading to substance abuse and subsequently addiction.

#ADHD #adhdtwitter #ADHDers
Read 4 tweets
This year International Day of Persons with Disabilities is highlighting that not all disabilities are visible. Disabilities are diverse and they can be dynamic. I have #EDS and I never know what my day is going to be like 1/
Sometimes I can go for a hike, other times I'm using mobility aids. I have to do a morning check to see how I'm feeling before I leave and that is just something I do. 2/
Although I have a genetic disorder that has affected me since I was a child, I used to be a ballet dancer. In fact, I used to dance 30 hours/week. Many people from my past would probably never have thought that I was disabled. I didn't think I was! 3/
Read 6 tweets
Did you miss the talk "Panorama of #lupus in 2020?" I did yesterday for @LupusEurope?

No worries, I'm starting a #tweeter #SLE #thread so that you can pick up the slides you're interested in 👍

Check below for the SLIDES ⬇️
Slide #1
Current classification of #Lupus
Slide #2
What is #lupus #SLE
#Lupusawareness
Read 18 tweets
1/12
Separating the #men from the #boys
Here is a #PubMed #indexed, #Elsevier published #journal reporting '#exclusive' #treatment of #covid19 through #Ayurveda leading to full recovery in a #patient. Great #news right?! No. The #proof of the #pudding is in the eating! Spoons out
2/12
The #journal. Its legit, 'becoz' its publishd by #Elsevier. Journal ownd by World Ayurveda Foundation & Trans-Disciplinary Univ, #Bengaluru. 4mer, a 4-men 'world foundation'[bit.ly/3is0CdR], latter @TDUFRLHT founded @sampitroda, vettedby likes of @kiranshaw
3/12
The study - 43yr old #newyork #banker develops fever,cough durng peak #COVID season, 'PRESUMED' to be #coronavirus. Self #Quarantine at #home, phone calls #ayurvedic #Doctors at #Chennai, #india, offer☎️ treatmnt until fever break, therby reporting #covid19 cure via Ayurveda
Read 13 tweets
1) I lose track of some things I’ve written about so I’ve compiled this #thread of threads. For context
I’m a 60 year old #ActuallyAutistic woman in the U.K. only recognised as being #autistic at 58. This is a purely personal perspective on
#autism
#Neurodiversity
#AutisticJoy
2) A year on from my #autism diagnosis I wrote this thread, with reflections on the process of being assessed as #ActuallyAutistic very late in life.
#autism
#ageing
#OlderAutistics
3) My (autistic) election experience (I keep trying to stay away from politics but failing. It matters far too much).
Read 25 tweets
#Poly_Cystic_Ovary_Syndrome PCOS

PCOS is a HORMONAL DISORDER that affects Women of REPRODUCTIVE AGE (16 - 45 years of age).

1 out of 10 (10%) of ladies are diagnosed with PCOS. 🚺

#PCOS affects woman’s hormonal levels thereby AFFECTING the OVARIES.

A Thread 👇 Image
In HEALTHY WOMEN, the ovaries produce a very small amount of MALE HORMONES called as ANDROGEN.

But In PCOS, due to #INSULIN_RESISTANCE, the ovaries produce EXCESSIVE androgens, RATHER than the female hormones (such as Estrogen & Progesterone). ❌

These Excess #ANDROGENS are
responsible for CAUSING lots of body changes SUCH as : Facial Hair (beards) & No or IRREGULAR menstrual flow.

POLY-CYSTIC means ‘Many Cysts.’

In PCoS, Many CYSTS (Small Fluid-filled Sacs containing IMMATURE EGGS) develops inside the Ovaries.

The EGGS are NEVER fully grown to
Read 9 tweets
#RareDiseases are not rare. One example is Hyper-IgD Syndrome, an #autoinflammatory / #PrimaryImmunodeficiency disease. Wonderful collaboration extending over 5 years between Kozhikode Medical College, CMC Vellore and CSIR-IGIB as part of the #GUaRDIAN journals.plos.org/plosone/articl… Image
Our #genomic analysis suggests that a few variants account for the majority of the patients with HIDS in South #India with implications in #diagnosis, as well as in the development of cost-effective approaches for #genetic #diagnosis and #screening

@Primary_Immune @MoHFW_INDIA
Read 3 tweets
1/n
Sorry to burst your bubble but NOT #Ayurvedic contribution

📌Quinine/Chloroquine
-Traditional-Peruvian
- identified by Jesuit Priests - isolated by Pelletier & Caventou (French Pharmacologists)
- isolated by Hans Andersag (German Scientist)
#MedTwitter #MedStudentTwitter
2/n
📌Reserpine (old world blood pressure drug) - identified in Rauwolfia serpentina in South Asia by botanist Rumpf of Dutch East-India Company, isolation by Műller, Schlittler & Bein (Germany)

➡️ In India isolated earlier by Bose&Sen, modern scientists -for psychosis treatment
3/n
📌Artemisin -from Traditional Chinese Medicine - isolated by modern medicine trained Chinese Pharmacologist Tu-Youyu

📌Metformin(diabetes drug) -from Galega officinalis[French Lilac], from European Folklore, isolated and improved -Muller&Reinwein,Germany & Leclerc,France
Read 8 tweets
There's a big difference between HAVING data at this level of #granularity, and PUBLISHING it.

Providing #age, #sex and street #address is not "#anonymised"; more like mildly #deidentified - and almost certainly still #PersonalData.

What the UK's "getting wrong" is a failure...
...to adequately #test - and further, a failure to get (positive) test results to where they are NEEDED.

Would you prefer your #COVID19 #diagnosis to be #published, or to get to you, your #GPrecord and to the #PublicHealth teams who are the ones having to manage things locally?
Data is not magic, and to be useful it must be done right.

Greater #transparency of the #systems, their #performance, and the people who are #using our data (and for what) would inspire greater #trust than putting 300,000+ people's on the web.

Assuming things were working, ofc.
Read 4 tweets
Strange cause for #cirrhosis
Maybe very #rare #MedEd
53yrs man, voice change, recurrent headaches, male breast enlargement. Stops socialising. Has bleed one day, #endoscopy varices, #biopsy fatty liver cirrhosis
No metabolic syndrome.
MRI Brain done. #livertwitter #radio
1/3 Image
What is the diagnosis?
In patients with cirrhosis, always try to find the cause in those who present early. There is no idiopathic, no cryptogenic. Its all 'missed' cirrhosis.
2/3 #liverpath
#MedTwitter #pathology #radiology #MRI #brain #Neurology #Endocrinology #NeuroTwitter Image
#diagnosis: #fatty liver related cirrhosis due to #pituatory macro adenoma with high prolactin, high GH, low #thyroid function. #clinical examination, acromegaly features with central obesity. #Examine 1st, then investigate. #MedicalStudent #medicine #MedStudentTwitter
3/3
Read 4 tweets
#Ayurvedic treatment of fatty #liver – real world evidence: A #Thread
1/n
Overweight woman, early 40’s. Routine liver tests, mild enzyme abnormalities. Advised #ultrasound liver, showed grade 2 #fattyliver. GP advised vitaminE and #weightloss, review in 3mo
#livertwitter
2/n
Patient and husband doubtful. Hears fatty liver disease can lead to #cirrhosis. Seeks advice from #Ayurvedic practitioner nearby #home since #Herbal #DRUGS = safe. Assures complete #cure through #Ayurveda. Prescribes multiple #medicines, advises almost all foods restriction.
3/n
Lets look at medicines. #tablet APFIL. Packet mentions ‘for liver #diseases’. Which liver disease? There is #alcohol related, #hepatitis B/C, #NAFLD, primary biliary #cholangitis and more causes. Nine #herbs extract combo - clinical #evidence on safety and benefit ❌
Read 14 tweets
I’m level 37 ✨✨✨
Celebrating that I’ve been keeping myself alive - and well - for the last 37 years living with type 1. This month marks my #Diaversay. As I don’t know the exact day of my #diagnosis - it was at the beginning of the summer break - I have decided it's July 7 🎉 Image
I had been having the usual symptoms for some time before I arrived at my grand parents for the holidays: weight loss, unquenchable thirst, constant peeing. My grandma realised something was wrong and took me to the GP.

#type1diabetes #invisibleillness #diagnosis
I thought I’d share a throwback picture to remind me how far I’ve come with living with #T1D for 30+ yrs: rigid treatments in the 1980s, denial in my teen yrs, hiding to inject my life saving #insulin, 1st pump in 2009, 1st #CGM when I was pregnant in 2010, & looping last yr 🟢 Image
Read 4 tweets

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