Discover and read the best of Twitter Threads about #endocrine

Most recents (9)

Interesting to see anti #obesity and #diabetes #medication management from the perspective of PharmDs

I'm always pro-collaborative care!

Here are some learning points and fact checks:

#AACE2023 #endocrine #endocrinology #pharmacology

1/
- "Tirzepatide is a dual agonist"
👉It ↑GIP activity but GLP-1R agonism is less than that of endogenous GLP-1
- "Hypoglycemia is not a concern if you're not on insulin"
👉Risk of hypoglycemia ~1.4% vs. 0.2% in placebo in SURMOUNT-1

nejm.org/doi/full/10.10…

2/
- "In this pt with uncontrolled #diabetes, A1c 7.4, we decreased glargine by 10% [when we started tirzepatide]"

👉 Not sure where the evidence is here, but the SURPASS-5 trial protocol reduced basal by 20% in participants with baseline A1c<8

jamanetwork.com/journals/jama/…

3/ Image
Read 5 tweets
Preoperative approach to sellar region masses, what the surgeon needs to know (at least what I think they need to know)

Additional reporting tips from surgeons are welcomed and encouraged! #Neurosurgery @TheASNR #radres #MedEd #MedTwitter #futureradres #endocrine #Neurology
1️⃣Where is the mass located?

Is it sellar based? suprasellar (S)? clival? Planum sphenoidale (PS)? Tuberculum sellae (arrow)?

▶️Location can change operative approach including but not limited to subfrontal vs transsphenoidal
2️⃣Where is the normal pituitary gland?

▶️this can be tough when the mass is large but the normal tissue often enhances more avidly than tumor so look for a strip of relatively avid enhancement along the periphery of the mass. Surgeons do not want to remove normal pit tissue
Read 10 tweets
I usually tweet about #obesity but since I recently had a pt with type 2 #diabetes go from 100 units/d insulin to 0 with tirzepatide, this is a good time to review #insulin management when you start a GLP1 / GIP

#endocrine #endocrinology #research #clinicians
1/
SURPASS-5: tirzepatide + basal insulin vs. placebo

Method: If baseline A1c<8, ⬇️long acting insulin dose by 20% at start of study

Result: At end of study, insulin was ⬇️11% for 15-mg tirzepatide group vs. ⬆️75% for placebo

jamanetwork.com/journals/jama/…

2/ Image
SUSTAIN-5: semaglutide 1.0 + basal insulin vs. placebo

Method: If baseline A1c<8, ⬇️long acting insulin dose by 20% at start of study

Result: At end of study, insulin ⬇️15% for 1-mg semaglutide group vs. ⬇️4% for placebo

academic.oup.com/jcem/article/1…

3/ Image
Read 7 tweets
Sehr aktueller Preprint zu #longcovid und #Genalayse und #GProteinGekoppelteRezeptoren

Kurze Zusammenfassung / Short summary of this data analysis

Long COVID: G Protein-Coupled Receptors (GPCRs) responsible for persistent post-COVID symptoms biorxiv.org/content/10.110…
Durch computergestützte Methoden wurden 255 #LongCOVID-#Symptome analysiert und die dazu relevanten Gene identifiziert.

This work utilised computational methods to analyse the persistence of COVID symptoms after recovery and to identify the relevant genes.
Protein-protein interaction network overview. Nodes = proteins, edges represent the interaction between two nodes (proteins). The top 10 key hub #genes of 255 symptoms of #longcovid are related to G-protein coupled receptors shown in circular nodes in pink.
Read 11 tweets
#thyroid #endocrine

1/4

THYROID AND HEME

1. Thyroid and RBCs

We often order a TSH as part of the w/u for anemia. But do we really understand the connection between thyroid disorders and anemia? Is there a causal relationship? If so, how common a cause are they?
2/4

2. Thyroid and other cytopenias

Did you know that hyperthyroidism may be associated with leukopenia, (microcytic) anemia, thrombocytopenia and even pancytopenia?
3/4

3. Thyroid and hemostasis

... and did you know that hypothyroidism is associated with a HYPOcoagulable state, while hyperthyroidism is associated with a HYPERcoagulable state?
Read 4 tweets
Cause of coma in a #woman surprised us!

1. 65-year old woman was brought in an #unconscious state to #emergency dept. She sounded normal over phone to her son about 24 hours earlier. She stayed alone, so, further details were not available.
#MedTwitter #internalmedicine
2. Clinical examination revealed an #unconscious patient. She was afebrile; pulse and BP were normal. Pupils were equal and reacting to light. Meningeal signs were absent. She was electively mechanically ventilated in view of her unconscious state.
3. Serum #calcium was high (13 mg/dL). MRI brain was normal. Lumbar puncture was normal. Investigations were done to determine the cause of high calcium. There was no evidence of #endocrine disorder, infection or #Cancer.
#VitaminD level was very high (160 ng/mL).
Read 7 tweets
Autistic Women & medical conditions thread 🧵 RE: Common #Medical symptoms and conditions in #autisticgirls #autisticwomen
By @sbaroncohen et. al I feel this research study has implication on #autisticgirls #gender #ROGD #trans #detrans In my #Autism clinic it has
been common to hear about #puberty #Dysphoria
Menstrual problems, #PMDD #PCOS & #endometriosis What is really nice for clinicians is when we see research that backs up our clinical work. In consideration Of #gender distress #dysphoria #ROGD we should be considering this research ImageImageImage
In making clinical decisions that impact #autisticgirls #autisticwomen with #ROGD #trans #detrans This July 2021 study looked at common medical conditions in #autistic females.
For some time, researchers have been investigating #sexbias in #autism diagnosis. #Medical
Read 18 tweets
Le twitter-graph de @genefutures ! #GrapheEcologie

C'est une tentative d'analyse d'un compte Twitter sous forme spatiale et graphique, via ces followers.

Je ne connais pas de quoi le compte parle, mais les followers me le diront.

HD, explications et analyse dans le thread⬇️
Si vous êtes pressés et que vous voulez allez vous même fouiller dans la version HD du graphe, il est dispo sur ce lien:
easyzoom.com/imageaccess/03…

Sinon, on va l'expliquer et le regarder ensemble en dessous
L'analyse de ce graphe a été fait en partie grace aux indications de @Florielvm, qui a pu me faire une breve présentation de "qui est qui", connaissant bien le milieu "Ecologisme associatif et politique".
Read 53 tweets
I have spent the last few years trying to rethink #mhealth. As we work to lessen #stigma and fear I ask everyone to keep an open mind, give feedback, and join me as I delve into some unique hypotheses. 1/
This started with my sphere of mental health. (Pinned) . I don’t believe true “normal” exists and feel everyone has issues that fit within the sphere. A dx comes because of observations that are inherently flawed & variable due to relative perceptions. 2/
I use the word “flawed” because none of us can read minds, therefore, there is no objective way to truly know exactly what someone is going through or how extreme their suffering is. This is one reasons #mhealth pros have such a difficult job. 3/
Read 25 tweets

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