Discover and read the best of Twitter Threads about #diagnosis

Most recents (24)

Back to basics‼️

A tweetorial on a clinical approach to #joint #pain 🪡

The 🔠ABCDE approach

🅰️ Articular (or not!) 🦴
🅱️ Background (& burden) 🎒
C Chronology 🕰️
D Distribution 📍
E Extra-articular 🍂

Let’s dive deeper

#RheumTwitter ImageImageImage
#Pain is #inflammatory if worst in the AM/ after rest

#Swelling which is not bony #Synovitis the sine qua non of #inflammatory #arthrits

#Stiffness esp in AM & > 1 hour

“How do you feel when you wake in the morning?”

is a great question to ask

#RheumTwitter ImageImageImageImage

Age 🕰️
Gender ♈️♎️
Race 🧕🏻

And 🅱️ = Burden👩🏻‍🦼
#impact of disease

#RheumTwitter ImageImageImageImage
Read 6 tweets
I have never been one for social media, but this is the first time I wish I could somehow write a tweet that goes viral…

I have a really important thing to say regarding bias towards women in medicine being real and affecting every single one of us.
(Long 🧵…)

I don’t like to share personal experiences, but in this case, I will make an exception…

@Dysautonomia @LauraAPace @MetrodoraInst @dys_project @dysclinic @EpilepsyFdn @epilepsysociety
For context, I believe it is important for you to know that I am a Biotechnology Engineer and a Master of Science in Neurobiology. I also have a rare #epilepsy which presents itself as #dysautonomia, which is not common…
Read 26 tweets
1/ Ever wondered how the 4th industrial revolution (#AI, robotics, and big data) is reshaping healthcare? 🏥 🚀
Let's dive into some fascinating facts and insights I found in the #book "Deep Medicine" by @EricTopol
2/ 💻👨‍⚕️ Electronic Medical Records (EMR) are mostly designed for billing, not for physicians' ease of use, contributing to doctor burnout 😩
How can we leverage #AI to improve the EMR and serve both purposes effectively? #HealthIT
3/⏱️ Did you know? If physicians make a #diagnosis within 5 minutes, they have a 95% chance of getting it right (System 1 thinking). This rate can drop to 25% afterward!
How can we harness #AI to assist in faster, more accurate diagnosis?
Read 10 tweets
[World #IBSAwarenessMonth] Dear #HCPs👩‍⚕️ & #Microbiota community👨‍🔬, April is dedicated to raising awareness about #IrritableBowelSyndrome

During the month, @Microbiota_Inst will provide you with content about #IBS, a common & complex #disease

#GutHealth #LetsTalkIBS #thread👇 Image
[World #IBSAwarenessMonth]

🔎 You will:
👉better understand the🔗between #IBS & #microbiota
👉discover potential ways to manage the #disease
👉learn to make a #diagnosis with our #CME courses, #videos & a professionally designed #tool
👉improve communication with your #patients
[World #IBSAwarenessMonth]

1️⃣ In this sequence, learn more about the link between #microbiota and #IrritableBowelSyndrome.

#IBS #MedTwitter #GITwitter #GutHealth #LetsTalkIBS #DGBI #FGID #GIfellows #TakeIBSSeriously

Take a look! 👇 Image
Read 17 tweets
#LongCovid is correlated with the #SpikeProtein protein. #Diagnosis

In this study, SPIKE antigen detected most often in 60% of the PASC patients and in > 70% of patients who reported ongoing cardiovascular, systemic, head-eye-ear-nose-throat, and musculoskeletal symptoms.
If viral reservoirs persist in the body of PASC patients, why do we not also detect N in more patients? Active viral reservoirs could cause PASC symptoms, but circulating spike may also give rise to symptoms.
Although spike does not instigate a cytokine storm in PASC patients, spike alone has been shown to induce dysfunction in pericytes, vascular endothelial cells, and the blood–brain barrier
Read 7 tweets
1/2 "#COVID-19 infection, including long-COVID, is associated with increased short- and long-term risks of #CVD and mortality."

#cardiovascular #disease #health #COVID19 #SARSCoV2
2/2 "Ongoing monitoring of #signs and #symptoms of developing these #cardiovascular #complications #post #diagnosis and up till at least a year post recovery may benefit infected patients, especially those with #severe #disease."

#PASC #LongCovid
1/2 "Compared to #uninfected individuals, the likelihood of #COVID-19 patients dying was up to 81 times higher in the first three weeks of infection and remained five times higher up to 18 months later."

#SARSCoV2 #COVID19 #cardiovascularhealth
Read 4 tweets
A woman who had a constant urge to move her right leg while sitting or lying down

1. 42-year old woman consulted me last month with complaints of constant urge to move her right leg for past 12 years. Symptoms occurred mostly in evenings and nights.
#MedTwitter #neurotwitter
2. She would develop crawling sensation and discomfort in right leg while sitting for long or lying down, which would go away only after she jerked or vigorously shook her leg.
She remained reasonably well during the day.
3. These symptoms occurred on daily basis causing sleep disturbance (she could #sleep only 5 hours at night).
She felt tired during day and found it hard to concentrate.
She was unable to sit for long while travelling or during meetings during daytime.
Read 10 tweets
#Genomics is a rapidly growing field of #science that has revolutionized the way we understand #biology.
It has #applications in diverse fields. From #healthcare and #biotechnology to #climatechange, genomics is leading to some of the most exciting and world-changing discoveries in science and #medicine like:
1. Predicting Disease Risk:📊

Genomics can detect diseases long before symptoms present themselves. Early #diagnosis of a disease can significantly increase the chances of successful treatments like #cancer, #diabetes, #autism, etc.
Read 8 tweets
Make this make sense to me 🧵@JudiciaryUK & @MyCafcass say I cannot see my children ever again until I complete 3-5 years of very specific therapy. @NHSKentMedway refuse to provide this treatment… Because there is nothing wrong with me other than trauma & grief - I’ve pleaded
I’ve begged, I’ve screamed, I’ve cried and cried, I’ve said without the treatment I’ll never be allowed to see them. I’ve been begging for 3 STRAIGHT YEARS. Their response @GregClarkMP is that I don’t have any mental illness, just substantial and soul destroying separation grief
So, The entire medical @NHS do not recognise the horrific diagnosis given to me and accepted by the courts as valid at all. But the court does not accept the @NHS medical response as valid either? No private psychologist in the country will agree to the @KentSocialCare terms
Read 12 tweets
I’m celebrating the 4th #autieversary #autiversary of getting my v late in life #autism diagnosis today.
Here’s a thread of some of the #threads I’ve written along the way, starting with my 1st anniversary when I wrote about my beloved dogs.
Nearly two years on from my #diagnosis I wrote about how much I had discovered about #autism and myself.
On the second anniversary of my #autism diagnosis I wrote a thread about #bullying (not realising that it was my #autieversary at the time). It was very appropriate though, as bullying and abuse have had a huge impact on me, especially in adulthood.
Read 8 tweets
Sponsored by @Roche,
I would like to share a Tweetorial about recent important advances in the management of advanced/metastatic triple negative breast cancer (mTNBC)

#Tweetorial #Oncology #Cancer #Diagnosis #TNBC #Immunotherapy #PDL1
TNBC is a challenging disease to treat due to its aggressive behavior, heterogeneity, and the lack of universal actionable targets. mTNBC is commonly diagnosed at a younger age than other BC subtypes and its prognosis is poor, with a median survival of <2 years.
Advanced TNBC can result from recurrence after treatment in the early-stage disease setting, or it may be diagnosed at initial (de novo) presentation
Read 12 tweets
Several people asked me why I was bothering to get an autism assessment when I was almost 59.
My children were adults, my career was on the wane, I had already lived a lot of my life.
What difference would it make for me to discover that I was #ActuallyAutistic then?
I knew I was autistic long before the psychologist told me.
I’d met other autistic people in an online forum and recognised myself.
It was undeniable.
I awaited the result of my assessment with trepidation simply because I knew some people wouldn’t accept self-identification.
This has turned out to be a profound discovery.
In many ways my late in life enlightenment has been life changing.
Someone I interviewed years ago said ‘once I understood I could cope’ (this has been true for me too).
An overarching theme is being able to make sense of things.
Read 16 tweets
Therapist Tip: 1 in 44 children are now born with #autism A core theme in many #autistic #aspergers #adhd individuals is self hatred or self-loathing, in both the diagnosed & undiagnosed. Many are unaware they are #neurodivergent Many are misdiagnosed or have missed diagnoses
Those who were late diagnosed (after kindergarten) are included. A common theme is growing up feeling 'different', 'not fitting in', being bullied, not being accepted, 'feeling like an alien', not understanding oneself, confusion, negative self-esteem, #adhd #selfesteem
a lack of friends, family of origin issues, difficulties communicating, being misunderstood & #trauma They may have ptsd from childhood, developmental trauma, have been bullied and/or abused. They often feel as though something is inherently wrong with them (shame & guilt) #PTSD
Read 16 tweets
Dear #hr in #niin #ksom #usc, I know you are busy,but could you spend 8 mins on my emails pls? I sent 6 emails from April to June, and called you every day this week, but I didn’t get any reply. #neuroscience EAD will be expired at 07/10😩@USC @KeckMedUSC @KECKSchool_USC @USCNIIN ImageImageImageImage
Thanks,friends in #twitter in #niin,#ksom, #usc, in #neuroscience, #neuroimaging, #neuroradiology. I really appreciate your support. I got the email this afternoon. It’s my fault. Even leave, leave with pride, grace, and gratitude, no regret. The 4 yrs will be the best memory in Image
my life, although it is also the hardest 4 yrs. Hope other colleagues could take my lessons, and prepare everything earlier in the future.
Read 31 tweets
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:… 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…
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

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.

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

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

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.


#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
H pylori #tweetorial for resistant H pylori
#AGA released CPU in 4/21 revisiting topic of resistance/treatment failures, not a guideline, but the expert opinion @BradSpellberg loves! (1/x)…
@ABsteward @RushCCH_ID #MedEd #medtwitter #idtwitter
As GN bacteria go, it's an interesting bug:
Highly motile, curved, GNR, #Urease-positive, catalase-positive, oxidase-positive
Related to Campylobacter, for family fun
Nice crossover with our #Gastroenterology colleagues, eh #IDtwitter and @IDSAInfo
GN, and as such should be sensitive to most #antibiotics that target GN with pretty good susceptibilities over time for:
#amoxicillin #tetracycline #aminoglycoside #nitroimidazole #macrolide
Read 25 tweets
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…

🧵 Image

✅10% of stroke, based on autopsy studies
✅More prevalent in #African Americans, #Hispanics, and #Asians as compared with whites

Other risk factors in table Image

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
🔹… Image
Read 13 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
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

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