Anti-acidity medicines increase the risk of heart attacks

1. Proton pump inhibitors (PPIs) like omeprazole, esomeprazole & rabeprazole are commonly used for treating GERD and other acidity-related disorders.
A recent study looked at long-term PPI use and risk of heart diseases.

2. 19,229 adults with type 2 diabetes were followed up for about 11 years.
Long term PPI users had 27% higher risk of coronary artery disease; 34% higher risk of myocardial infarction, 35% higher risk of heart failure & 30% higher risk of all-cause death, as compared to non-users

3. The mechanism of PPI increasing the risk of #heart diseases could be: the effects of PPI on altering gut microbes and their interaction with anti-platelet agents (PPIs may reduce the bio-availability of clopidogrel).
#MedTwitter #Gastroenterology #gerd

Read 4 tweets

Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Lesser night #sleep and daytime #napping increases the risk of inflammatory bowel disease (#IBD)

1. 4,88,000 people aged 40-69 were followed up for 12 years. 1 in 200 (0.5%) were diagnosed to have IBD. 31% had Crohn's disease, 69% ulcerative colitis
#MedTwitter #Gastroenterology

2. Compared with participants with a sleep duration of 7 hours/day, those with a sleep duration of ≤5 hours/day had a higher risk of:
Inflammatory bowel disease: 36% higher
Crohn's disease: 53% higher
Ulcerative colitis: 29% higher

3. Compared with participants without daytime napping, those with daytime napping had a higher risk of:
Inflammatory bowel disease: 13% higher
Crohn's disease: 25% higher
Ulcerative colitis: 9% higher

Read 4 tweets

Antonio Guerrero

@guerreroespejo

An 81-YO👵, type 2 DM: malaise, fever & anorexia, with oral pain & odynophagia, yellowish-white, pseudomembranous lesions on the tongue (A)

#endoscopy showed multiple shallow ulcers with a white coating (B)
1/6

doi.org/10.1503/cmaj.2…
#emergency #gastroenterology #MedEd

Glossal & esophageal🔬: multinucleated cells with moulded, ground-glass nuclei

PCR & immunohistochemical staining of the specimens: ➕ for herpes simplex virus type 1 (HSV-1)

HERPETIC GLOSSITIS AND ESOPHAGITIS
2/6

#GIPath #IDtwitter #microbiology

Her hemoglobin A1c was 7.2%.

Doctors treated her with a 7-day course of acyclovir, intravenously because of her odynophagia, and the oral and esophageal lesions completely resolved.
3/6

#MedStudentTwitter #MedicalStudents

Read 6 tweets

Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Repeated abdominal pain and vomiting could be a sign of "Abdominal Epilepsy"

1/n
Abdominal pain & vomiting are common symptoms of many gastrointestinal disorders. However, in some patients, no obvious cause can be found despite extensive investigations.
Case report
#MedTwitter

2/n
22-year old woman presented with repeated episodes of epigastric #abdominal #pain associated with #vomiting of three months duration. Symptoms occurred almost on daily basis, more in evenings, post which she felt tired and lethargic. She was evaluated by gastroenterologist.

3/n
Extensive investigations- upper GI endoscopy, CT and ultrasound of abdomen, LFT, serum amylase, etc were normal. Symptomatic treatment also did not help. At this point she was referred for my opinion.
#gastroenterology #internalmedicine

Read 5 tweets

Christian Thoma MSc PhD

@DrChristianThom

@gerdosi

It's not just what you eat that influences your #gut #microbiome, but also the medication (not just antibiotics).

We now need to be thinking about that more carefully when studying #diet, #prebiotics, #probiotics, #gutbrainaxis and the #microbiota

#Gastroenterology

@gerdosi

https://twitter.com/JonathanStineMD/status/1582730016395526145

"Individuals exposed to multiple drugs, polypharmacy, showed distinct gut microbiome structures harboring significantly more abundant upper gastrointestinal species and several nosocomial pathobionts due to additive drug effects."

"Polypharmacy was also associated with microbial functions, including the reduction of short-chain fatty acid metabolism and increased bacterial stress responses."

Read 4 tweets

Top Biomedical Science

@imedverse

@ManualOMedicine

Causes of acute pancreatitis

@ManualOMedicine #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #GITwitter #Gastroenterology

Causes of Acute Pacreatitis

#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #GITwitter

Acute Pancreatitis – Causes, Pathology, Symptoms and Signs, Investigations, Management and Complications

#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents

Read 4 tweets

Pediatric on Squares

@OnSquares

Welcome everyone to our 2nd Pediatric on Squares Board Review Course
We are starting today until the coming 8 days
Hope it’ll be helpful and enjoyable course
✏️ Note that you still can join and register on the course with accessibility to all recorded session until 27th of August

@Bassemkurdi

Day 1
1st session: Pulmonology Review
By Dr. Bassem Kurdi @Bassemkurdi

#Pediatric #Pulmonology #MCQ

@aalnemri

Day 1
2nd session: Keys to Answer MCQs
3rd session: Neonatology review
By: Prof. Abdulrahman Alnemari @aalnemri
#Pediatric #Neonatology #NICU #MCQ

Read 23 tweets

ICMR

@ICMRDELHI

@MoHFW_INDIA

1/n) ICMR released Standard Treatment Workflows (STWs) volume 3 which contains 11 specialties with 52 diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App.
@MoHFW_INDIA @DeptHealthRes #STW

@MoHFW_INDIA

2/n) Standard Treatment Workflows (STWs) on #𝐃𝐞𝐫𝐦𝐚𝐭𝐨𝐥𝐨𝐠𝐲 containing 14 major diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App. @MoHFW_INDIA @DeptHealthRes

@MoHFW_INDIA

3/n) Standard Treatment Workflows (STWs) on #Endocrinology containing 06 major diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App. @MoHFW_INDIA @AyushmanNHA @WHOSEARO #diabetes

Read 12 tweets

Dr. Nishant Kanitkar

@DrNishant_

I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇

Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
#PLAB

1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
#PLAB

Read 60 tweets

BrandlertheBMMD

@JBrandlerMD

@Gut_BMJ

#LowFODMAP Diet, restriction phase x 2 wks done!😅

✅Hardest #GIEmpathyInitiative yet (5 pts!)
✅Worth it b/c 🤯reflections in🧵⬇️

Disclaimer: LFD is🙌for some w/ #IBS but NOT good fit/safe for all

@Gut_BMJ 2021 Network MA on LFD in IBS @alex_ford12399
pubmed.ncbi.nlm.nih.gov/34376515/

@KateScarlata_RD

1⃣Hardness of diet complexity:
✅❓rhyme/reason to👍vs.👎fruits/veggies
✅#Glutenfree🚫always safe (fillers!)
✅ If packaged you just avoid b/c label reading =😱
✅🙌@KateScarlata_RD for LFD label reading tips gastrogirl.com/626/
✅Apps @MonashUni app ($8), FastFodmap(free)

@NICEComms

2⃣Hardness of diet behavior change:
✅Eating out = embarrassing to be "that person" + 😱spice situation
✅NEED coach (dietitian) to guide/remind of goals
✅If eat like🗑️at baseline,❓sustainability ➡️maybe why many patients preferred @NICEComms diet
cghjournal.org/article/S1542-…

Read 9 tweets

Yan Leyfman, MD

@YLeyfman

@Yale

Happening now!

A discussion about Gastroenterology & the latest developments chronic diarrheal syndrome from one of GI’s global leaders-- Dr. Paul Feuerstadt from @Yale (@DrPaulGastro)

Youtube stream:

Clubhouse link: clubhouse.com/event/maWRBOp8…

https://twitter.com/YLeyfman/status/1501000702994235392

@lexyv717

@lexyv717 @etahmed @LVento @drysilay @CParkMD @evolusean_ @MedNewsWeek

@Yale @YaleUniver @YaleAlumAssocNY @cpgYALE

@EMJGastro

@EMJGastro @GIconnectInfo @doccohengastro @ghettogastro @amergastroassn @sages_updates @natrevgastrohep @icds2020 @cdiff_papers

#medicine #gastroenterology #gastroenterologist #cdiff #clostridiumdificile #nejm #infectiousdiseases #infectionprevention #infectious

Read 6 tweets

James Wilson, DO, FAWM, CTropMed®

@JamesWilsonDO1

@BradSpellberg

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)
gastrojournal.org/article/S0016-…
@ABsteward @RushCCH_ID #MedEd #medtwitter #idtwitter

@IDSAInfo

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
(2/x)

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
(3/x)

Read 25 tweets

ACG

@AmCollegeGastro

Time to register for #ACG2021 Annual Scientific Mtg & Postgrad Course!

Reconnect.
Renew Friendships.
Refresh Your Knowledge.

➡️acgmeetings.gi.org

Things we forward to LIVE & IN-PERSON:

‼️ Seeing colleagues in #GIcommunity‼️

#Gastroenterology #GItwitter #ACGfamily

#ACG2021 It's time to sign up!
ACG Annual Scientific Mtg & Postgrad Course

➡️acgmeetings.gi.org

Things we look forward to LIVE & IN-PERSON:

‼️World-class clinical education‼️

#Gastroenterology #GIcommunity #ACGfamily #GItwitter

#ACG2021 Registration is open!
ACG Annual Scientific Mtg & Postgrad Course

➡️acgmeetings.gi.org

Things we look forward to LIVE & IN-PERSON:

‼️Celebrating & uplifting #DiversityinGI‼️ #DiversityEquityandInclusion

#GIcommunity #ACGfamily #GItwitter

Read 11 tweets

(Cyriac) Abby Philips

@drabbyphilips

@SRajesh_IR

1
Sharing our invited review: Transjugular intrahepatic portosystemic shunt (TIPS) in #cirrhosis/World #Journal of #Gastroenterology. @SRajesh_IR helms 24-page colossus discussing exhaustively recent studies #livertwitter #MedTwitter #irad #GITwitter
Full: bit.ly/3ib7Frp

2
Topics we discuss include - variceal bleeding (incl ectopic), #ascites & #hydrothorax (incl chylous), #complications, new techniques, #stent size dilemma & extensive point of care algorithmic approaches in portal hypertension complications, eg: esophageal #variceal bleeding 👇

3
#New techniques such as combined approach for difficult anatomy situation in TIPS in cirrhosis 👇

Read 7 tweets

Dr. Akshay Kothari

@akkified

@EricTopol

#Doctors and #Medicine need an #AI update.
Bold and convincing book.

@EricTopol

#ArtificialIntelligence has the ability to bring the fourth industrial revolution. Healthcare is deemed to be an industry which can get transformed the most.

#DeepMedicine

@EricTopol

@EricTopol is a #cardiologist, historian of the present and a #MedicalFuturist.
He believes that the way we practice medicine now ( #ShallowMedicine ) relies too heavily on human inputs and is thus plagued by human biases and imperfections.

#DeepMedicine

Read 23 tweets

Richard Jones

@forensicmed

@llantwit

"Ever get the feeling you've been cheated?" (John Lydon)

The publication of this letter & the nature of its correction raises questions about the reliability of the academic record.

@llantwit @FFLMUK @RCPath @AAPTTweets @mike4path @Richard56 @JJPJ #autopsy

THREAD

1/14

https://twitter.com/RetractionWatch/status/1263773214343262209

@SureAndShare

When the letter by Won Sriwijitalai & Viroj Wiwanitkit was published in #JFLM, fact-checking journalists @SureAndShare in Thailand shared their concerns about it on @Twitter & @Facebook.

2/14

@SureAndShare

@SureAndShare were concerned that they were unable to verify who the 1st author was (or where they worked), or the death of a #forensic #medical professional from #COVID19. They cautioned against sharing the story.

3/14

Read 15 tweets

Dmitriy Kedrin MD, PhD

@GI_Pearls

1/14 "In defense of Simethicone" - a Tweetorial for #GITwitter, #Gastroenterology - Instead of focusing on why we can't use Simethicone, I'll try to show you why we (endoscopists) should put it in the water, if u haven't, or re-start if you stopped.

2/14 - When you are doing a colonoscopy, bubbles are your enemy. There are now countless studies showing that adding simethicone improves both colon prep, inspection time, and most improtantly - Adenoma Detection Rate.

3/14 - Now the first mention of using Simethicone in the water bottle that I could find dates to 1995, so not too long ago. Ever since then, many docs, all over the world used it, and believe me when I say, if you forget to add it to the water, you really notice its absence.

Read 16 tweets

Eric Topol

@EricTopol

@tberzin

Our new @ThaLancet Digital Medicine essay is especially timely
thelancet.com/journals/lance…
It's on #AI-assisted endoscopy w/ @tberzin, a co-author and collaborator in 3 randomized clinical trials @BIDMChealth

@tberzin

@tberzin @BIDMChealth Of the 6 randomized trials of #AI in medicine published to date, 5 are in #gastroenterology, using real-time machine vision during endoscopy. All of these were conducted in China.

@tberzin

@tberzin @BIDMChealth Unlike other deep neural networks for medical imaging, it requires real time assessment to detect an adenoma and decide whether a biopsy is indicated.
This video from Japan's @LPIXEL_Inc shows where the field is headed #AI

Read 5 tweets

Eric Topol

@EricTopol

@LancetGastroHep

There have only been 5 randomized clinical trials of #AI in medicine to date. Here's the summary:
4 in gastroenterology (2 @LancetGastroHep, 2 @Gut_BMJ)
1 in ophthalmology (@EClinicalMed)
All were conducted in China
(None in radiology, pathology, dermatology or other specialties)

@LancetGastroHep

@LancetGastroHep @Gut_BMJ @EClinicalMed What constitutes suitable evidence for clinical implementation (and surveillance after) for #AI in #healthcare?
Here's @d_spiegel's take:
hdsr.mitpress.mit.edu/pub/56lnenzj @pubpub @harvard_data

@LancetGastroHep

@LancetGastroHep @Gut_BMJ @EClinicalMed While there are now hundreds of in silico, retrospective dataset reports, the number of prospective (non-randomized) trials in a real clinical environment testing #AI performance is limited. I only know of 11. Let me know if I'm missing any.

Read 7 tweets

Birmingham Health Partners

@BHPComms

@qehbham

Not sure what to expect at the 2019 BHP Research Showcase? Our free public event will be held at @qehbham on Fri 17 May, where you can get hands-on with our health research. If you want to #BePartOfResearch, take a look through our exhibitor info THREAD > birminghamhealthpartners.co.uk/research-showc…

@ICVS_UoB

Our #cardiology stand will focus on current studies that are changing & saving the lives of our patients. Our cardiology team is one of the largest in the UK and works closely with @ICVS_UoB to treat every type of #heartdisease
#BePartOfResearch

@UmbrellaHealth

.@UmbrellaHealth is the home of #sexualhealth services for Brum & Solihull. They'll be here with interactive displays highlighting research into #HIV and #STIs, including #antimicrobialresistance and bacterial vaginosis >> umbrellahealth.co.uk
#BePartOfResearch

Read 23 tweets

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