Discover and read the best of Twitter Threads about #pediatrics

Most recents (17)

1/3 Síntomas de #COVID19 en la infancia y niñez incluyen una gran variedad. En la foto los más comunes. Recuerde llamar a su médico/pediatra para solicitar su número de récord médico y ver si su pediatra está realizando consultas por telemedicina.
2/3 Importante evitar las visitas a Salas de Emergencias a menos que sea indicado por un profesional de la Salud y/o su niño/a se complique. Según los datos actuales, pocos son los casos donde la niñez se complica, pero es importante mantenernos alerta. @CDCespanol @WHO #COVID19
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1/
ATOPIC DERMATITIS - a #dermatology #tweetorial/#medthread!

For all the #tweetiatricians, #primarycare, #medtwitter, & #dermtwitter! #MedEd #FOAMEd pc:@dermnetnz

1st, a question:
How do you think of the term atopic dermatitis (AD) in relation to the term eczema?
2/
If you're a purist, "eczema" is a description. When a #dermatologist says something looks eczematous, it doesn't mean it's AD. It means it has a certain appearance.

So the right answer for purists is "AD can cause eczema."

That said, we so often just use eczema to mean AD🤷🏻‍♂️
3/
As annoying as that might be, it's an important distinction. If you see an eczematous rash, you need to consider possible causes:

- Atopy
- Allergy/irritant contact
- Medications
- Venous stasis
- Dry skin

For more on contact dermatitis, check out @patchtestYu!
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1/
STAPHYLOCOCCAL SCALDED SKIN SYNDROME - A #dermatology/#dermtwitter #tweetorial!

Let's start with a question: You are seeing a new patient with a rash you suspect of being SSSS, but aren't sure if it might be bullous impetigo.

What test will help you differentiate the two?
2/
The correct answer is wound culture! SSSS should be sterile or skin flora; bullous impetigo will have lots of staph grow out. Keep reading to find out why! 👇

But before we get there, let's talk about the SSSS exam. The pic is a good example of "sad facies." pc:@dermnetnz
3/
The other great clue you are dealing with SSSS is the predilection for skin folds. This eruption can cause a high BSA of erythema --> desquamation.

SSSS is more common in the #pediatrics population, especially in kids <5 years of age (for all the #tweetiatricians out there!)
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1/
“The Erythemas” – A #dermatology #meded #FOAMEd #tweetorial. pc:@dermnetnz

Ever get all the different #dermatologic terms jumbled up? Was it erythema nodosum, erythema migrans, or erythema multiforme?

Honest poll – Ever write “rash” b/c you couldn’t remember the diagnosis?
2/
All kidding aside, these terms can get confusing. Remember though, derm terms are usually just descriptors of what you see. The name tells you all you need to know.

For example: Acute Generalized Exanthematous Pustulosis (AGEP) = pustules suddenly appeared everywhere!
3/
So, the “erythemas.” First off, what does “erythema” actually mean? Well, according to my Google machine, it's from the Greek root “eruthros” meaning “red.” So "erythema" doesn’t add much to our knowledge of what the rash looks like other than it’s red, and so, likely inflamed
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A last-day-of-pediatrics-clerkship thread.

#BuckleUp #MedTwitter #MedStudenTtwitter #Pediatrics

When my sister was 3 years old, my mom brought her to her general pediatrician for a regular well check.
She was a healthy appearing, curious and impassioned 3 year old. I wasn’t there but I imagine her pediatrician had to use the kind of magic only pediatricians have to get her to sit still for the visit.
I imagine that maybe he and my mom chatted casually about life’s happenings as he proceeded with the physical exam. I imagine that the exam was made challenging by my sister who was probably squirreling around, excited about the lollipop or sticker that awaited.
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#i2 1/17 It's that time of year again - the national conference of @AmerAcadPeds is this weekend in #NOLA. Once again, there's a "session" with a misleading title: "Common Problems of the Genitalia in Newborns and Infants." An ethical practitioner would read that title & think...
@AmerAcadPeds 2/17 the session will cover diseases, deformities, other adverse penile conditions & their diagnosis or treatment. After all, that's what the ethical practice of medicine in general, & #neonatal #pediatrics in particular, is all about: patient presents w/problem, pediatrician...
@AmerAcadPeds 3/17 diagnoses and appropriately treats problem. But this is @AmerAcadPeds, where no one in charge gives a #flyingflamingo about their ethical duties to their child patients, & where a surgeon's Toyota #Camry won't pay for itself. Read the blurb & you'll see this session isn't...
Read 17 tweets
Syphilis! RMSF! Hand-foot mouth!

Slow down there, Tiger! Let's dive deeper into:

ACRAL RASHES - a #tweetorial/#medthread
(aka rashes on the "palms and soles" - kind of 😉).

#MedEd #FOAMEd #medtwitter #dermtwitter #dermatology #dermatologia pc:@dermnetnz
1/
No where else on the body does a rash evoke more of a knee-jerk differential. That's not wrong per se, as we all learn this in med school, but it's more complicated then starting doxycycline and checking an RPR!

Let's start with a definition - what does "acral" actually mean?
2/
Technically, "acral" just means our distal body parts. So while we often think of palms and soles, it's actually inclusive of the whole hand, the whole foot, ears, and some include even the nose!

I actually didn't learn this until #derm residency, which was shocking to me.
3/
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Hi #pediatricians, our work on #disparities in #disability id. was just cited by the @AmerAcadPeds in their #policy statement on the impact of #racism on children's health. Our most recent study was cited. If helpful, here is a thread of our work to date. #RacismAndHealth (1)
@AmerAcadPeds Here is the abstract and link the the study cited in the @AmerAcadPeds policy statement. journals.sagepub.com/doi/pdf/10.310…. We find that children of color are less likely to be identified as having disabilities than similarly situated students who are White in U.S. schools (2)
@AmerAcadPeds Here is an example finding. Of U.S. 4th grade students displaying clinically significant reading difficulties, 74% of White students are receiving special education. The contrasting percentages for Black, Hispanic, and American Indian students? 44%, 43%, and 48%, respectively (3)
Read 15 tweets
All right #medtwitter, you asked, & I'm going to try to deliver. Here's a #tweetorial/#medthread on...

#ALOPECIA!

***I'm not a hair expert, but hopefully this will just provide a framework to think about this problem***
#dermtwitter #MedEd #FOAMEd #dermatology pc:@dermnetnz
1/
Let's say a patient complains of his/her hair falling out. In the spirit of examining first as #dermatologists tend to do, let's start with the exam. This is the easiest way to differentiate between the two types of alopecia: scarring and non-scarring. What do you look for?
2/
While all the above options can help with the ultimate diagnosis, it's the preservation of follicular ostia (or loss of said finding) that helps point you in the right direction. Whether it's scarring or non-scarring can really help narrow your differential.
3/
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It's #tweetorial time! Read on for a #medthread on:

Cutaneous Small Vessel #vasculitis (CSVV)!

#MedEd #FOAMEd #dermtwitter #dermatology #medtwitter #rheumtwitter pc: @dermnetnz
1/
I've heard different ways to organize the vasculitides over the years, but by the far the most common is by vessel size. As a #dermatologist, I see the small vessel vasculitides most often, so we'll focus on that today. Yes, Takayasu's important, but I'll save that for later!
2/
There is a relatively limited list of possible diagnoses with CSVV. I've included the most common below.

The blue I lump together as they are similar, and biopsy results help you differentiate.
The red are the ANCA-associated.
The green are the unique ones.
3/
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Let’s talk #VaccineLiability. There’s a vaccine court that has a lower evidentiary bar than any civil court in the US. If a plaintiff fails there, he can STILL sue in civil court afterward. Our system does protect families. #VaccinesSaveLives
Let’s talk #VAERS. It’s an important database in which anyone can voluntarily report any effect of a vaccine: injection site soreness,fever,fussiness,redness. I’ve reported. So when #ProPlague #Antivaxxers quote numbers, just ask for the breakdown of VAERs reports.#VaccinesWork
The #VAERS system helps monitor concerning symptoms that could start to appear (eg, ⬆️’d soreness or fever with a specific batch of vaccines). It helped identify concerns w/rotavirus so it could undergo rigorous safety testing. It’s a great 1st step in safety.#VaccineMonitoring
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Mnemotecnias Médicas👩‍⚕️👨‍⚕️🌏🌍🌎

Abro 🧵iniciamos👨‍💻y abierto los comentarios

#FOAMed #FOAMped #medtwitter #Urgenciologa #Urgencias #MedStudentTwitter #Pediatrics #Pediatria #FOAMex #UCIP #UTIP #PedsICU #ENARM2019 #MIR2019 #FACMED
Son tres los objetivos, donde el principal, es compartir y fomentar el conocimiento útil en la práctica médica
Saber que puede usarse tanto nemotecnia como mnemotecnia según @RAEInforma
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Monitoreo de CO2 Exhalado

Abro hilo, iniciamos 👨‍💻y abierto los comentarios

#FOAMed #PedsICU #Urgencias #Pediatrics #SoMe #FOAMped #Pediatria

@sgdambrauskas @CantillMauricio @AMEEMCTI2018 @OlgaPena @diegovinci @ESACMex @SaidDLCR @Javier_Prego @erikablasco ¡Ayuda a compartir!
Un caso clínico no ayudará a entrar al tema, veremos conceptos básicos de #EtCO2, y algunas de sus aplicaciones clínicas en Urgencias y #UCI
Caso clínico
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Traumatismo Craneoencefálico Severo 🧠 #TCE

Abro hilo, iniciamos 👨‍💻 y abierto los comentarios

A propósito de la publicación del @PedCritCareMed

@MarianaPediatra @FOAMexico @CantillMauricio @FOAMedMX @FranLoachamin @PatologCritica @ecameselle @RobustosMD @naidxielli 🔁
90 artículos contribuyeron a la evidencia, 68 describían protocolos aplicados para el manejo

Documento intencionado a uniformar la práctica clínica y mejorar desenlace, intentando motivarla innovación y búsqueda en áeras donde la evidencia es escasa
Objetivo del algoritmo es su utilidad en el manejo general en #PedsICU en el TBI severo así como aspectos específicos

La #CT valora la extensión de la lesión cerebral y la necesidad potencial de intervención quirúrgica

El monitoreo de #ICP para guiar la terapia de la ICP y #CPP
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It's been about a week, so I thought it'd be a good time for another #dermatology #tweetorial/#medthread! Let's talk about another derm emergency that really gets me worried for the patient: #purpura fulminans (PF)!

Thanks @dermnetnz
1/
#FOAMed #MedEd #dermtwitter #medtwitter
What is purpura fulminans? It's basically retiform purpura, EVERYWHERE! But what is retiform purpura? It's the sharp angulated purpuric plaque/patch you can see in the skin. When you see retiform purpura, it means there's likely either a vasculitis or vasculopathy causing it!

2/
Why does that happen? (Nerd-alert - this is one of my favorite ah-ha moments from residency) - The skin is perfused in cones, so if you knock them out, you get circles of necrosis. When you combine a bunch, you get the angular appearance! See my terrible MS paint attempt:

3/
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@RichDuszak 1- MT @Aiims1742 “This @katekelly article reads like a paid infomercial for EPIC (in fact, I actually looked for the “This is an advertisement” disclaimer). Would have been nice to have interviewed one or two end users of the chocolate factory product.”
nytimes.com/2018/12/20/bus…
@RichDuszak @Aiims1742 @katekelly 2- Nice digs, clever marketing spin, BUT Epic highly disliked by users. #EHR has significantly disrupted relationships w #patients, #ptexp, led to clinician & pt dissatisfaction, & is seen as one cause of #burnout. @JackMurtha hcanews.com/news/ehrs-are-… @BarbaraMcAneny @meggerber
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Nursing, a thread:

Saturday- my kid and his family kicked my butt, wore me out, had me frustrated, emotional, overwhelmed.

Sometimes you advocate so hard, and people listen and don’t listen and challenge you and you leave exhausted.

I didn’t want to do it again on Sunday.
Sunday- I have the same kid back.
He’s sedated/intubated

I don’t expect many changes for the day, but the team had other plans so we end up cutting sedation & preparing for extubation.

These are all good signs. The family is excited. The patient is scared
I get the family to leave the room, and the patient nods and tears up when I ask him about his worries.

Seeing absolute fear in a child’s eyes pulls your heart harder than anything else. I hold his hand, pray with him, we listen to his favorite music, & put on a brave face.
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