Discover and read the best of Twitter Threads about #doctor

Most recents (24)

Clinical presentation and virological assessment of 181 confirmed human #monkeypox virus cases in #Spain
✔️92%, gay men, bisexual men, or other men who have sex with men (MSM) &
✔️8%, heterosexual men or women

(A) genital & pubic region pustules
👇
thelancet.com/journals/lance…
✔️Median age was 37 years (IQR 31–42).
✔️18% patients reported previous smallpox vaccination
2/

(B) Three semiconfluent pustular #monkeypox lesions with a depressed centre located on the left side of the tongue dorsum.

#MedEd
✔️40% were #HIV-positive, 11% had a CD4 cell count less than 500 cells per μL

✔️17% were diagnosed with a concurrent sexually transmitted infection

(C) Pearly acral #monkeypox vesicles embedded in the thick stratum corneum of the palmar skin, shotty on palpation
3/

#IDtwitter
Read 9 tweets
A 40-year-old woman from Brazil, AIDS, CD4 91 cells/μL: headache, diffuse cerebral edema, coma, respiratory distress, tracheal secretion with nematode
(1), alveolar hemorrhage, periumbilical purpuric rash (2), & death

🔬brain: 3
1/

doi.org/10.1093/cid/ci…
#MedEd #IDtwitter
🔬tracheal secretion: Strongyloides stercoralis (1)

Skin biopsy: S. stercoralis larvae at the dermis and hypodermis.

DISSEMINATED STRONGYLOISIASIS WITH EXTENSIVE CUTANEOUS AND CEREBRAL INVOLVEMENT
2/5

#microbiology #MedStudentTwitter
Strongyloidiasis occurs worldwide, but predominates in tropical and subtropical areas.

People acquire the disease from penetration of larvae through the skin.
3/5

#MedicalStudents #MedTwitter
Read 5 tweets
Clinical features and novel presentations of human #monkeypox of 197 patients in a #London centre during the 2022 #outbreak

Median age: 38 years
All 197: men, &
196 identified as gay, bisexual, or other men who have sex with men
1/

bmj.com/content/378/bm…
#IDtwitter #MedTwitter
Concomitant infection:
- 35.9%: HIV
- 31.5%: a concomitant sexually transmitted infection.

All presented with mucocutaneous lesions, most commonly on the genitals (n=111 participants, 56.3%) or in the perianal area (n=82, 41.6%).
2/

#Doctor #MedStudentTwitter
86.3% participants reported systemic illness:
✔️ fever 61.9%),
✔️ lymphadenopathy (57.9%), and
✔️ myalgia (31.5%).
3/

#monkeypox #resident
Read 14 tweets
👩‍🦳 in her 70s: on the L 🦶, initially appeared pruritic papules that evolved to fluid-filled blisters with tense and denuded bullae (Fig1).

Over the ensuing 6 weeks an expanding annular plaque with peripheral scale (Fig2).
¼

DOI:doi.org/10.1016/j.mayo…
#dermatology #mycology
🔬(KOH): hyphae
🧫: Trichophyton rubrum

BULLOUS TINEA PEDIS.

The patient responded well to terbinafine cream and dilute acetic acid soaks.
2/4

#microbiology #IDtwitter
Bullous tinea, seen in adults and children, and most often affecting the feet, presents with an erythematous scaly rash with serous fluid-filled bullae, as opposed to the pus-filled blisters of bullous impetigo.
3/4

#MedTwitter #Doctor #MedStudentTwitter #MedEd
Read 4 tweets
18-YO👨‍🦱: painful tender, fluctuant mass mass over the R anterior sin, chronic right knee pain, weight loss.

Leukocytosis
⬆️inflammatory markers (ESR, CRP)

XR & MR: ?
1/

doi.org/10.1093/cid/ci…
#Orthopedics #radiology #MedEd
X-ray: areas of lucency & sclerosis in the proximal tibial metadiaphysis
MR: consistent with an chronic osteomyelitis & intraosseous abscess with myositis involving the adjacent musculature

A presumptive diagnosis of BRODIE ABSCESS
2/

#IDtwitter #MedTwitter
Debridement with sequestrectomy
3 deep bone: Aggregatibacter aphrophilus
🔬: bone remodeling, fibrosis, & mixed lymphoplasmacytic & histiocytic infiltrates

BRODIE ABSCESS OF THE TIBIA DUE TO AGGREGATIBACTER APHROPHILUS
3/

doi.org/10.1093/cid/ci…
#microbiology #Doctor
Read 9 tweets
A 28-YO👨‍🦰traveling through Africa & Asia: a pruritic, erythematous rash on his back, trunk, buttocks, genitals, & lower limbs; dry cough & wheeze

X-ray: bilateral reticulonodular infiltrates
Eosinophilia
1/

doi.org/10.1093/cid/ci…
#IDtwitter #MedTwitter #dermatology ImageImageImage
CUTANEOUS LARVA MIGRANS (CLM) & LOEFFLER SYNDROME

The “creeping” skin lesions are diagnostic of CLM

The pustular rash across the patient’s buttocks & back is likely secondary to CLM folliculitis—a rarer, but well-described skin manifestation of CLM
2/

#Doctor #MedEd ImageImage
The patient’s cough and chest radiograph findings are characteristic of Loeffler syndrome, a recognized but rare complication of CLM.

CLM is caused by the infective stage larvae of animal hookworms from the family Ancylostomidae.
3/

#MedStudentTwitter #resident Image
Read 7 tweets
42-YO African American man, AIDS, CD4 57 cells/ mm3: 18-mth of progressively multiple papules coalescing into large exophytic nodules & plaques on face, scalp, & neck (A & B); & several lesions in in the groin, penis, & RUE
🔬:?
1/

doi.org/10.1093/cid/ci…
#dermatology #idtwitter ImageImage
GIANT MOLLUSCUM CONTAGIOSUM

Molluscum contagiosum is a benign skin tumor caused by molluscum contagiosum virus.

Lesions >1 cm diameter are known as giant molluscum
2/

#Virology #MedEd #MedTwitter
Well-circumscribed intraepidermal lobules containing molluscum bodies (arrow)
These structures, which are composed of viral particles & cellular debris, are pathognomonic for this condition
Molluscum bodies enlarge and rise to the surface as cells age
3/

#Doctor #dermatologia Image
Read 8 tweets
.

Unknown deaths in Alberta and New Brunswick

But it's definitely not the clot shot they got

.
#Alberta #NewBrunswick #Deaths #MysteriousDeaths #vaccine #BigPharma #CrimesAgainstHumanity #Meme Image
.

Hotter nights increase the risk of death from heart disease for men in early 60s

It's definitely not the clot shot they got

. Image
.

Lonely older women at greater risk of heart attack, study shows

It's definitely not the clot shot they got

. Image
Read 18 tweets
No, no it doesn't. The #prevention of dental disease is in the patients hands, thank goodness. Now if only #Dentistry would get behind #prevention, that would be swell.
Heckuva job, #Doctor.
"Potential"?
Read 6 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
Lactante 4 meses, dermatitis atópica, su hermana con laringitis aguda: erupción papulosa de evolución a costras en 1 día, predominando sobre placas de eccema preexistentes.

Se inician en el tronco, incluyen cabeza, área del pañal y vesículas en boca.
1/5

#pediatria #Pediatrics
PCR (para herpesvirus y enterovirus):➕para enterovirus Coxsackie A6

ECCEMA COXSAKIUM

El A6 produce también: erupción vesículo-bullosa erosiva, cuadro Gianotti-Crosti-like y rash purpúrico-petequial

✒️Martín A y col continuum.aeped.es/screens/play/5… @aepediatria #dermatology
2/5
@aepediatria El eccema coxsackium puede producir fiebre con pápulas, vesículas y costras confluyentes en región peribucal, cuello, tronco, antebrazos, pantorrillas y dorso de manos y pies.

Generalmente, una enfermedad autolimitada con buen pronóstico.
3/5

@ContinuumAEP #Pediatrics
Read 5 tweets
1) How I cured my #LongCovid in 3mos after suffering for almost a year. This was my last hope. I researched what #Covid does to the body, came up with a list of "clinically studied" supplements and...
2) took them all. Firstly, I am not a MD. In March 2021 I caught Covid while working as a #frontline #healthcare worker. My symptoms of #brainfog, #fatigue, #jointpain, #muscleweakness, morning #stiffness happened after my recovery. At the time, this #postcovid #syndrome was...
3) was just starting to be discussed online. The the term #Longhauler was coined. Those in the #ME, #CFS, #Lyme #MCAS #community starting speaking out about the similarity of #symptoms with #LC. #Covidclinics started to sprout up, include one at the....
Read 48 tweets
Recién nacida, bajo peso al nacer: lesiones cutáneas vesículoampollosas anulares, violáceo-grisáceas, de predominio en espalda y miembros, con descamación de🤲y plantas, aspecto séptico, irritabilidad y tremulaciones
½

DOI: 10.1016/j.anpedi.2020.05.012
#pediatria #Pediatrics
Serología para sífilis de madre y RN:
PCR de Treponema pallidum (lesiones y LCR):➕

SÍFILIS CONGÉNITA PRECOZ

2/2
✏️MV Ordoño y col.
analesdepediatria.org/es-sifilis-con…
#microbiology #dermatology #MedEd #IDtwitter
La recien nacida recibió 10 días con penicilina G sódica I.V., con cicatrización de las lesiones del pénfigo sifilítico al nacimiento, persistiendo alopecia residual

#MedTwitter #Doctor #MedStudentTwitter
#resident #medicine #MedicalStudents #pediatric
Read 3 tweets
16 meses, dermatitis atópica: erupción vesículo-ampollosa, con agrupación distal, con edema (1 y 2), vesiculación y costra central; peribucal y nasal, con costras de aspecto melicérico (3) y erosiones en área del pañal
¼
👇
DOI: 10.1016/j.anpedi.2020.10.012
#pediatria #Pediatrics
PCR (frotis faríngeo, rectal y vesículas):➕para enterovirus. Se identificó Coxsackie, serogrupo A6

ECCEMA COXSACHIUM

Forma de enfermedad mano-pie-boca atípica, por serogrupos menos frecuentes, como Coxsackie A6
2/4

✏️D Pérez-González y col
analesdepediatria.org/es-eccema-coxs…
#pediatric
Esta variante de enfermedad boca-mano-pie presenta erupciones vesículo-ampollosas generalizadas, con predominio en zona perioral, área del pañal y extremidades, especialmente en zonas de dermatitis atópica.
¾

#MedEd #IDtwitter #MedTwitter #Doctor
Read 4 tweets
Thread for Doctors (a thread to be updated time to time)

I will write here about,
What doctors can do to protect themselves, against complaints under SC/ST Act, complaints in police for medical negligence, complaints for medical negligence in

#Doctors #MedTwitter #India
2/ police station, complaints filed in criminal courts, summons by court to private doctors to appear as a witness with medical record of a patient, cases in civil court for damages, steps a doctor can take if he perceives threats from a patient, etc.

#doctors #MedTwitter
3/ First basic principles : An error in diagnosis (or Judgement) is not by itself a negligence. If a patient dies during an operation or immediately after surgery, is by itself not a medical negligence.
Read 37 tweets
Exactly 7 years ago, I spent #StrokeAwarenessDay undergoing emergency #thrombectomy for #basilar artery occlusion. #BAO

Today, I'm still in awe and celebrating how #modern #medicine saved me from locked-in syndrome and enabled me to live a normal life, against all odds.

1/ 🧵
2/ So far, I have avoided sharing this information as part of my professional life, fearing it would somehow disqualify me as a credible clinician-scientist. Finally, I realize that the experience only strengthened my resolve to give future patients the second chance I was given.
3/ What happened in brief:

I was a healthy, 25yo medical student, all excited to have finished the first 10K run of my life not even 5 hours before my family reacted #FAST and called 911.
Read 20 tweets
Duration of Antibiotic Therapy
Deciding on the duration of antimicrobial therapy for an infection is neither straightforward nor simple. 👇
#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor
#medschool #MedStudentTwitter #medstudent #TwitterRx
🔽👇🔽🔽👇

/1
Most ID guidelines are based- either expert opinions or evidence-based medicine. Historically, duration of ABX Rx were based on arbitrary extension of days(magic numbers like 7, 10 & 14 days) rather than on reliable evidence with the main aim to ⬇️ failures & avoid underRx.

/2
There is growing evidence to support for shorter courses. It is important for prescribers to be up to date with best practices. Duration of therapy plays a pivotal role in antimicrobial stewardship programme within the global effort to optimize antibiotic use &⬇️resistance.

/3
Read 26 tweets
LASIX and HF
👇👇👇👇
#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor

👇👇👇

/1
4-chloro-N-(2-furyl-methyl)-5-sulfamoyl-anthranilic acid, member of the sulfa’s. Potent natriuretic drug, inhibits Na+-K+-2Cl− cotransporter in the ascending limb of the loop of Henle.
Direct Vd effects results in its therapeutic effectiveness in the Rx of acute pulm edema.

/2
Vasodilation leads to reduced responsiveness to vasoconstrictors, such as angiotensin II and noradrenaline, and decreased production of endogenous natriuretic hormones with vasoconstricting properties.

/3
Read 15 tweets
Angioedema:

Edema of the deep dermis & subcutaneous tissues.

Etiology, types and treatments👇👇👇👇⬇️⬇️⬇️⬇️👇👇👇👇

/1


#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor
👇⬇️⬇️⬇️⬇️👇👇👇👇
Mast cell–derived mediators tend to affect layers superficial to subcutaneous tissue, including the dermal-epidermal junction. These mediators cause urticaria & pruritus.

In bradykinin-mediated angioedema, the dermis is usually spared, so urticaria & pruritus are absent.
 
/2
Read 7 tweets
Pseudomonas aeruginosa (PA):

Gram-negative bacillus found widely in nature, in soil and water.
/1


#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor @ImproveDX
The genus Pseudomonas >140 species,> saprophytic & >25 species are associated with humans. Most known to cause disease in humans are associated with opportunistic infections.

⬆️ MR : ⬇️ host defenses, resistance to ABX & production of extracellular enzymes & toxins.
/2
Often found in water in sinks & can contaminate respiratory equipment, which can serve as an environmental reservoir, especially in ICUs. Is the most serious pathogen causing ventilator-associated pneumonia & remains the most important pathogen in patients with CF.
/3
Read 15 tweets
Dementia
Acute cognition change with altered consciousness & impaired attention that fluctuates over time. Often unrecognized & unRx. May be preventable & early detec/ facilitates urgent assessment &Rx 1/16
#MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor
The criteria for delirium listed in the Diagnostic and Statistical Manual of Mental Disorders vs Confusion Assessment Method (CAM) 👇👇. CAM has a sensitivity of 94% to 100% and a specificity of 90% to 95%.
2/16 Image
Features:
disturbances of sleep, altered psychomotor activity, and changes in emotion (eg, anxiety, apathy, lability, irritability, or anger). Subtypes of delirium are hyperactive, hypoactive & mixed. Hypoactive form >> hyperactive form. Inattention is hallmark. 3/16
Read 17 tweets
The HPA Axis and Adrenal Fxn.
Typical excretion of cortisol ➡️diurnal pattern with peaking in the a.m, ⬇️toward the afternoon, & ⬆️ in the early p.m. The basal adrenal production of cortisol is 10-15 mg daily. #MedTwitter #MedEd #USMLE #FOAMed #hospitalist #mbbs #medicine #doctor
Physiologic & psychological stress can boost daily production of cortisol to 3 or more times typical levels.
Adrenal insufficiency: caused by a disease involving the adrenal gland itself (primary AI) or one altering its regulation by the hypothalamus and pituitary (secondary AI)
Primary AI results from destruction or replacement of the adrenal cortex. Addison’s disease (autoimmune destruction of the adrenal cortex) accounts for 80% to 90% of primary AI. Image
Read 13 tweets
In case anyone is wondering how we NHS Nurses are doing out here- read this.
Because you need a subscription to read the full article I’ve added screenshots tothisThread
#NHS
#LongCovid

Nurses with long-COVID: NHS urges trusts to redeploy,not dismiss. rcni.com/nursing-standa…
Read 4 tweets
#AIMART storytime 🧵
This just in: Boom💥
So, I’m getting ready for work today, tying up the ol’ scrubs and peek at my phone - I see a message, sent last night from the ER doc stating that one of my patients, a young Black man admitted for Sickle cell pain crisis...

1/
..., wanted to leave and the doc was okay with discharging because the patient’s pain seemed to have resolved. Ok, I get to the 🏥and my team informs me the patient is still in-house (in the ED – No beds on the floors.

2/
The ED is overflowing, so we have patients admitted and waiting in the ED for a bed for daaaays on end. Coupled with the ED being short-staffed - yeah…not good) and didn’t leave, after my wonderful senior resident convinced him to stay and receive more analgesia (pain meds)

3/
Read 24 tweets

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