Discover and read the best of Twitter Threads about #pediatrics

Most recents (24)

Every year when the July 4 holiday weekend comes around, I go through my peds emergency med list of what I hope that maybe this year I won’t see, unlike in years past -

A short🧵-
All the burns -
- on the bottoms of kids’ bare feet from stepping on discarded still hot BBQ charcoal briquets
- on hands and in eyes from wayward sparks from home fireworks & sparklers
- painfully blistered sunburns from forgetting to reapply sunscreen
- a drowning (or more) from a pool party where everyone thought someone *else was keeping an eye on the kids
- an overheated child forgotten in a hot car, sometimes too late
Read 7 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
Niña de 5 años, araña entre las sábanas (1): fiebre de 2 días y placa eritematosa indurada en muslo con crecimiento centrífugo y una escara necrótica central (2)
¼

✏️M. Sendín-Martín y col. @HospitalUVRocio
DOI: 10.1016/j.anpedi.2020.12.005
#pediatria #Pediatrics
@HospitalUVRocio PICADURA DE LA ARAÑA RECLUSA PARDA

Las arañas del género Loxosceles o arañas reclusas o arañas violinistas debido a la morfología dorsal de su cefalotórax tienen una distribución mundial

La lesión se resolvió los días siguientes, sin dejar cicatriz.
2/4

#MedEd #dermatology
@HospitalUVRocio Las arañas reclusas parda causan lesiones necróticas a través de una enzima denominada esfingomielinasa D1. Los síntomas sistémicos incluyen fiebre o náuseas.

De forma infrecuente, signos graves como coagulación vascular diseminada o la rabdomiólisis
3/4
#IDtwitter #MedTwitter
Read 5 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
HEPATITIS AGUDA INFANTIL de origen desconocido

¿Realmente la está causando el #Adenovirus F41? 🧐

Hay algunos puntos a considerar. Va mi opinión al respecto🧵👇🏼

1/15

#HepatitisAgudaInfantil
Hace un mes (15Abr22) nos enteramos de que Reino Unido 🇬🇧 estaba reportando un incremento inusual en los casos de #hepatitis de origen desconocido en pacientes pediátricos, especialmente en l@s más jóvenes

Después otros países empezaron a reportar lo mismo (tot: 169 casos)

2/15
La presentación clínica, es decir, la manera en la que el personal médico identifica la enfermedad👩🏻‍⚕️, es una #HepatitisAguda (el surgimiento rápido de inflamación en el hígado) con una elevación muy pronunciada 📈 en los niveles de proteínas provenientes de ese órgano¹

3/15
Read 16 tweets
An in-depth review of Slipped Capital Femoral Epiphysis (SCFE).

If you're interested in orthopedics or pediatrics you'll definitely want to check this review out!

1/ Image
SCFE’s are an adolescent hip pathology with an average age of onset of 11-12.

The diagnosis may be initially missed because the patient may present with thigh or knee pain.
Risk factors include:
✯ Obesity
✯ Male gender
✯ Prior radiation
✯ Endocrine abnormalities
✯ Certain ethnicities (e.g. African American)

Obesity is one of the most important and modifiable risk factors.
Read 12 tweets
Had an opportunity to visit few #MTIs in #KPK with the purpose to explore #PedsICU infrastructure & need assessment and collaboration for capacity building. 1/12
Overall basic infrastructure is there and the need is unmet. And there is a desire on ground to build this field of #Pediatrics which is encouraging. The management is excellent and there is an #EHR in place. All these make an excellent starting point. 2/12
We need to keep few facts in mind while embarking on this challenging and but truly rewarding journey of providing quality acute hospital care to #children in #KPK & #Pakistan 3/12
Read 13 tweets
Thing is… even prior to #COVID19, it was known that viral shedding can occur in feces up to 3 weeks or longer. Isolation periods have always been subjective. That said, for airborne spread, there is a need to take precautions while infectious in that way #Omicron
Specific to #COVID19 (in #Pediatrics)

“duration of viral shedding in infected pediatric patients. Virus was detectable for a mean (SD) of 17.6 (6.7) days overall and was detectable for a prolonged period of time in all cohorts of children”

jamanetwork.com/journals/jamap…
Then this.

“Duration of symptoms ranged from 1 to 36 days. Positive tests were recorded up to a median of day 21 (range 6-38).”

pubmed.ncbi.nlm.nih.gov/33911876/
Read 8 tweets
This makes me so 🤢

The idea that women are automatically “safe” is exactly what creates this “opportunity” for some women to exploit children & monetize their “optics” of “trustworthy” on behalf of predators.

Gender does not predict ethics, integrity, safety.
Why does #GhislaineMaxwellTrial matter to #womeninSTEM?
⬇️federal funding
➡️private donors (Epstein)

“Socialites” open doors to elite spaces, including #academia #science #STEM
Women=“optics” & “reputation management” for these wealthy predator men

theverge.com/2019/9/19/2087…
These same connected women, often daughters of powerful businessmen

are on boards of #WomeninSTEM “empowerment” organizations or on #MeToo (TimesUp scandal)

the very women who are predators of young women are given access to women’s “safe spaces”? (!!!)

bustle.com/entertainment/…
Read 33 tweets
#antivaxx efforts now even use #deepfake

to target #refugee, Black, religious minority communities

like measles outbreak in Minnesota in 2019: Wakefield was flown in TO spread #misinformation & #disinformation

Now: online fake accounts/fake identities vs #VaccinesWork
What has #healthcare been doing meanwhile?

#Medbikini: Teach (male Asian) med students to make fake accounts to cyberstalk trainees’ personal Facebook for: bikini
or “being political” or “religious” (#BLM)

➡️“model minority” pipeline for “shadow faculty” vs Blck @ayshakhoury
#Medbikini #research got flak for men vs women

BUT was ALSO fake acct #surveillance vs #BLM like drove out @ayshakhoury @uche_blackstock @nhannahjones

While academia has ignored #vaccineequity
➡️ongoing #pandemic & deaths in marginalized targeted by #antivaxx

@womanistpsych
Read 23 tweets
This 👇🏽👇🏿👇🏻 This is why #BLM exists & why “implicit bias” is not only real but it kills

Why, when you see it, say something, do something
The system changes not by sharing tweets & hashtags but actions & consequences & removal of toxicity from the system

Follow #BlackTwitter
Above #MedEd #TikTok improvement: #citeblackwomen who lead this work (not only utilized the savior mindset of Black & brown as victims) #Blackexcellence @citeblackwomen center Black women
Send #SoMe traffic to Black creators & activists. #healthcare twitter.com/i/lists/122380…
Take #sharethemic initiative. It allowed #Blackexcellence to speak thru #influencer accounts to large followings for a day. I looked at before/after numbers, it did NOT drive any additional traffic to the actual accounts of those voices. Resurfacing this:

https://t.co/VZ26WWNxRP
Read 45 tweets
1/ With #Vaccines approved for 👧🏽👦🏾 5-11 yo parents have a decision to make. #Omicron reminds us we aren’t through this yet.

As a #Pediatrician I have spent my career helping parents make health care decisions about their kids. This🧵is about #risk and the decision to #Vaccinate
2/ The decision to #Vaccinate means you believe the benefit outweighs the risk - so let’s break it down starting with- what #risk does #Covid19 pose to our #kids?
3/ Acute risk in 5-11 yo from 🇨🇦 data:

Hospitalizations 🏥 in 0.2%
Death in 0.002%
#LongCovid in 2-5% (still learning)
#MIS-C 1/3500 cases (most common in 5-11 age group)

Let’s remember kids rarely die so this is on par with other diseases we prevent with #vaccination
Read 8 tweets
A thread of some useful & reliable resources on #COVID19 & #CovidVaccines 🧵⤵️

(I know it can be a challenge to stay up to date with lots of new information & questions! As I am currently "studying" for a Facebook Live tomorrow...)
Lots of expert-reviewed shareable content on vaccines, science literacy, public health, etc! @ScienceUpFirst scienceupfirst.com/share/
Really like the easy-to-understand infographics from Sabina Vohra-Miller via Unambiguous Science @SabiVM
unambiguous-science.com/infographics/
Read 15 tweets
I’m curious to know how pediatricians feel about off-label use of the COVID-19 vax for 2-4 year-olds once 5-11 year olds become eligible

Say FDA issues an EUA for 5-11 year olds this month: should off-label use for younger kids be allowed?

#MedTwitter #Tweetatrician #Pediatrics
Folks reacting to this that are not pediatricians:
🔸Off-label use in pediatrics is quite common, but not with vaccines
🔸Off-label usage would *allow* but not *require* parents of younger kids to get them vaccinated
🔸Work toward an FDA EUA is ongoing, this doesn’t change that
Hearing from some Pediatricians via QTs and DMs: so far, the “nays” have it. Specific reasons center around wanting to see the data for 5-11 year olds.

IOW: it’s premature to consider this hypothetical
Read 5 tweets
#LongCOVID

We reviewed 14 studies of persisting symptoms following #COVID19 in #children & #adolescents

Most had major limitations and should be interpreted with caution.

True risk is likely to be nearer 1 in 100 than often quoted 1 in 7.

#medpeds #IDTwitter

(Long) 🧵1/n
The 14 studies involved 19,426 children & adolescents.

Common persistent symptoms reported 4-12 weeks after acute #COVID19 were:

•headache
•fatigue
•sleep disturbance
•concentration difficulties
•abdominal pain.

Symptoms rarely lasted more than 12 weeks.
Read 13 tweets
I keep seeing hot takes on how covid affects kids + if it’s dangerous for them.

But amazingly there’s still a striking shortage of pediatrician voices given the opportunity to provide our nuanced and expert opinion.

What would we say if you asked us?

A thread 🧵
Pediatricians have a lot to say about the covid in kids, how to balance the risks and benefits of exposure, and how to make personal + public health decisions that prioritize the needs of children.

What would we say if asked how dangerous covid is for kids?
We’d ditch glib mortality statistics that dress up data as science + paint a more complicated picture.

We’d reassure you that children continue to mostly do well with acute covid. We’d then explain that deaths + hospitalization from acute covid are just part of the equation.
Read 15 tweets
Team it's time to address the Hoeg et al preprint on post-COVID vaccine myocarditis. How am I qualified to speak about myocarditis? I am board certified in paediatric cardiology and currently have patients recovering from this condition. TLDR: They are doing quite well. #MRI
What is the premise of that article? directly scanning VAERS data will result in capturing more cases of myocarditis, and therefore the "conclusion" that COVID vaccine generates a higher risk of myocarditis than COVID disease. But - cardiologists have diagnostic criteria. #heart
All that bleeds troponin is **not** myocarditis. I cite my professional society, the American College of Cardiology: #myocarditis #COVID19 #vaccination #VaccinesWork Image
Read 18 tweets
To reassure parents, a reminder of some key facts about #COVID in #children:
 
#SARSCoV2 infection remains asymptomatic or mild in the vast majority of children, even with the #DeltaVariant. Hospitalisation and deaths from COVID are still rare in this age group.

1/n 🧵
However, the greater transmissibility of the Delta variant means there is more COVID in *all* age groups, including children, so we will see more paediatric cases.
As a large number of older people are now vaccinated, the increase is blunted in the elderly so, compared with earlier in the pandemic, a higher *proportion* of current cases will be in children: this can give the mistaken impression that the Delta variant is targeting children.
Read 7 tweets
Within past few days the American Academy of #Pediatrics has quietly removed its "#Face Time & #Emotional #Health" info sheet (PDF) for parents w/ new infants.

It can still be found in web archives:

web.archive.org/web/2021081110…

[h/t @Bleedinheart2MD, @tapuaetai_l, @galexybrane]
American Academy of Pediatrics (AAP) & AAP Friends of Children Fund, partners & corporate donors:

Johnson & Johnson
Seqirus
Sanofi
Sobi
Nestlé
Abbott
Genentech (Roche)
Merck
GlaxoSmithKline
Kaléo
Novo Nordisk
Supernus

More👇

#4IR #Biotech #EmergingMarkets #SDGs
Do you see it yet?

With each passing day, children are being conditioned to endure a #4IR global architecture. The restructuring of the global economy. A societal transformation, global in scale.

"Who will thrive, who will perish?" (Deloitte)

#Digital transformation.
Read 4 tweets
I’m a Pediatrician = ❤️👶🏽🧑🏻👩🏾. I have worked in Children’s Hospitals, on medivac teams and now in the North. These are my thoughts on what we are facing with #Delta going into the fall
1. Wave 4 of #COVID will be a pandemic of #misinformation, under-vaccination and inadequate mitigating public health interventions (removing mask mandate, not addressing school ventilation, etc). We have reached the limits of what “encouraging people to get vaccinated” can do.
2. Who will pay the price? #Children, esp children < 12 who can’t be #VaxXed. It is misleading to say “not that many kids die”. #Mortality is a pretty crude outcome measure in #Pediatrics. What about disability, medical trauma, impact on families, mental health?
Read 8 tweets
New preprint 🧵🧵🧵: bit.ly/3zH0IYr
Led by @ SaahithiRao @MattKellyMD and @Duke_Childrens @DukeCHDI colleagues Wen Zhao, Jason Lang, Laine Thomas, and Ben Goldstein
#asthma #pediatrics #SARSCoV2
Remember how in #DukeBRAVEKids we found that kids with asthma seemed to be at lower risk of SARS-CoV-2 infection?
bit.ly/3x4F7ah
We decided to try to run that down using a population-level, retrospective EHR-based analysis from @DukeHealth
We identified every kid in the system (6,515) who met our asthma definition started (bit.ly/2V8DDPj), lived in Duke’s main catchment area, and had at least one encounter in the two years before the pandemic
Read 25 tweets
Multisystem inflammatory syndrome in children is driven by zonulin-dependent loss of gut mucosal barrier.. @vipintukur @ProfSomashekhar @naveenthacker @iapindia @INDIANJOURNALO4 @VirusesImmunity @EditorIndPed @ICMRDELHI @MoHFW_INDIA @iiscbangalore Image
Weeks after #SARS-CoV-2 inf or exposure, some children develop a severe, life-threatening illness called Multisystem Inflammatory Syndrome in Children (#MIS-C). GI symptoms are common in MIS-C pts & severe hyperinflammatory response ensues with potential for ❤️ complications.
👉🏽As proof of concept, they treated a #MIS-C patient with #larazotide, a #zonulin antagonist, & monitored impact on antigenemia and clinical response.
👉🏽in MIS-C, prolonged + of SARS-CoV-2 in t GI tract ➡️ to release of zonulin, a biomarker of intestinal permeability,
Read 14 tweets
Delighted to report our paper examining the ‘missing’ children from hospitals during the first COVID-19 UK lockdown has just been published in @EurJPediatrics
rdcu.be/clnF6
Explanatory thread below:
1/ We were interested in discovering which children were ‘missing’ from hospital services as the first lockdown started. We analysed anonymised records of patients <16yrs in 2 Oxfordshire (UK) hospitals, providing secondary & tertiary care.
2/ We looked across 6 years: in 2020 prior to, during and after lockdown & 2015-2019 across matched dates including the same number of weekdays/weekends. ICD10 codes gave us the diagnoses of inpatients across all 6 years to assess ‘missing’ diagnoses during lockdown.
Read 20 tweets

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