Discover and read the best of Twitter Threads about #pediatrics

Most recents (24)

2/
Classically placed in the arm
May be placed in the leg (eg in #pediatrics /neonates – which may then terminate in the infrarenal IVC/iliacs)
.
#criticalcare #cardiovascular
3/
Advantages:
- Lower infection rate then central lines
- Used in the outpatient setting
- Can be used for several weeks to months
- Duration of PICC lines may be from 4 weeks to 6 months
(although they have been known to be functional for more than 300 days)
Read 20 tweets
#medtwitter #meded #pediatrics #IMProud

Reflecting on an undeniable threat to our patients - pregnant Moms, children, seniors, families, communities

Denied freedom.. a 🧵

Denied freedom to

shop for a prom dress

walk the mall with your child

go to your doctor
2/?

Denied freedom to

worship

go to the supermarket

go to school

teach in school

To do these things without being snuffed out, there one second and gone the next

Freedom to breathe, to come home that day

Freedom to access life, liberty and the pursuit of happiness ->
3/

But freedom is layered, complex; each of us sees &lives it differently, we prioritize freedoms individually

Who’d have thought freedom, as foundational as we purport it to be, is so individually interpreted and variegate?

Why should a doc be tweeting this? ->
Read 12 tweets
Since ‘21 lawmakers proposed nearly 900 anti-#LGBTQ+ bills, nearly 500 of which were introduced this year in 49 state legislatures+Congress. Many bills target rights of #transgender people by curtailing “basic healthcare, education, legal recognition & the right to publicly exist
1) Many of the anti-trans bills target the rights of #transgender people by curtailing “basic #healthcare, education, #legal recognition, and the right to publicly exist” #LGBTQ thecrimereport.org/2023/05/16/a-s…
2) #NorthDakota recently enacted a statute restricting access to sex-segregated spaces apnews.com/article/transg…
Read 13 tweets
A summary thread from the great Emergency Medicine Australasia issue I finally read on the plane; @EMAJournal #foamed

Thom study in EMA: patients with unstable cervical #fractures can sit (29%), walk (63%), lack midline tenderness (27%), and have delayed presentation (20%).
@EMAJournal #emergencymedicine

surf injuries were mostly lower c-spine

NEXUS underperformed compared to Canadian C-spine.

#drowning and cervical CTs are not inextricably linked: don't automatically image unless signs of axial loading/very specific concerns
@EMAJournal [my $0.02 on immobilising (virtually) anyone prehospitally: cervical immobilisation is a myth: collars don't actually immobilise, and 'immobilisation' doesn't actually prevent neurological injury...it *does* however harm (eg aspiration and other harms)]
Read 31 tweets
⏭️Esta imagen a primera vista es muy sugestiva..¿Qué preguntarías ?
——
This image is very suggestive…¿What would you ask for?
#CaseChallenge #DermTwitter #MIR #ENARM 🕵🏼‍♀️🕵🏼‍♀️ Image
‼️Nunca olvidéis la regla de afectación Palmoplantar (adjunto mi regla)
Habrá que preguntar por todo esto.
El paciente relató relaciones sexuales de riesgo 2-3 meses antes, con una lesión oral (ya no presente en la exploración) que probablemente sería el chancro
Se realizó serología con pruebas reagínicas y treponémicas que confirmaron en diagnóstico y se pautó penicilina benzatínica 2.4 millones de unidades
A la revisión, a los 3 meses títulos de RPR en descenso y clínicamente asintomático Image
Read 5 tweets
A snapshot in time confounded by @TheNRMP match “algorithm”. The truth is #medicine is we have work to do in #genderequity - US physician workforce only 37% women. Rads 27%, Gen Surg 22%, #EM 👋🏼29%…@acepnow @WomenSurgeons @AmCollSurgeons @radiologyacr @EmergencyDocs @aawr_orgtwitter.com/i/web/status/1…
@AAMCtoday stats on 2021 US physicians by % female. #pediatrics 65%, #orthopedics 5.9%. Note surgical sub speciality ($$$) higher male dominance, medical/primary care higher female…#orthotwitter @aap_peds @aaos1
New generation of US #doctors show progress, by @aamc study on residents and fellows, 47% total female, #gensurg 46%, #radiology still only 27%, #emed 39%…
Based on the @StanfordMed graphic, we can assume why progress for gensurg but why not for Rads…
Read 9 tweets
1 year of pediatrics residency. My experience and Simple PTR for those interested in taking Pediatrics.

1. Be ready to lose a lot of pens and staplers. Never forget to carry spares. Also peds is incomplete without a simple measuring tape.

2. Be ready to be a part of /n
One of the most overworked departments if you choose a tertiary care hospital.

2. Learn to look. You'llget to see the most classical and the most obscure findings if you're observant enough.

3. A crying baby should never be ignored. Never move on if you dont find a reason /n
4. Never ignore a mother's complaint. For you its a patient, for her its her world.

5. Never take a symptomatic history. Never try to find a history based on the signs and symptoms you see. The parents out of frustration and agitation may say yes to everything you ask.
/n
Read 8 tweets
Young boy w/ acute onset quadriparesis with areflexia, admitted to ICU with "GBS". You happen to glance at Urine Bag. something is off! The old urine is darker!? The patient is squealing with abdominal pain. Relatives tell you- seizures in the past
Thoughts?

#MedTwitter
This surely doesn't feel like a routine GBS. Young boy with seizures and abdominal pain, think of the Porphyrias!

Our patient probably has one of the acute Porphyrias. Confirmation of the type eluded us unfortunately since genetic analysis is expensive. Probably AIP
Neuro Porphyrias include
1. Acute Intermittent Porphyria (AD)
2. Hereditary Coproporphyria (AD)
3. Variegate Porphyria (AD)
4. ALA Dehydrates Porphyria
Read 11 tweets
3VOLUTION of Homo sapien to HOM3OSTASIEN​

by Dmitry Kats, PhD, MPH
scholar.google.com/citations?user…

- - -

A HOM3OSTASIEN represents the evolutionary step forward undertaken by the homo sapien species (among other mammals) to substantially extend and reestablish healthy, fulfilling,… twitter.com/i/web/status/1…
... "inhibition of nuclear de novo NAD+ synthesis reduced the total levels of NAD+ in the cell and mitochondrial energy metabolism, leading to premature cellular senescence"

"nuclear de novo NAD+ synthesis pathway, controlled by H2AX [i.e., GPR109A aka HOM3OSTASIS.com/2022/11/homo-s…twitter.com/i/web/status/1… ImageImageImageImage
... Little do people know, as they don’t care to review the actual literature, that per se, akin to every other cell in the body, as proved in these high-profile journal-published papers (collecting Internet-dust) by the world's most elite investigators (scientists and/or… twitter.com/i/web/status/1… Image
Read 52 tweets
A 4-week-old male infant born at 33 weeks of gestation presented with this. Observe the child's 👀 carefully ... what is happening to the eyes while its mouth opens and closes?
#MedTwitter #MedEd #TipsForNewDocs #Pediatrics #FOAMed
@Sthanu5 @AvrahamCooperMD @PaediatricFOAM
▶️The mother's pregnancy was complicated by maternal syphilis and methamphetamine exposure.
▶️The baby subsequently was found to have a positive serum RPR (1:4) & positive VDRL in CSF (1:1)
▶️GE - hepatomegaly & syphilitic rhinitis (snuffles)-
▶️Diag: Neurosyphillis
▶️Synkinetic jaw movement with blinking - Marcus Gunn jaw-winking syndrome, a congenital cranial innervation disorder wherein a usually ptotic eyelid elevates with mouth opening.
▶️Other names :- trigemino-oculomotor synkinesis and pterygoid-levator synkinesis.
Read 9 tweets
A 2 m old infant , born at 35 1/7 weeks of gestation via LSCS with BW 2610 g due to preterm PROM, came with sudden-onset bilateral buccal protrusions. NO trauma history previously, nor were any congenital disorders found.
What is this...!?
#MedTwitter #TipsForNewDocs #Pediatrics
▶️physical examination revealed bilateral protrusions that were normal in color & texture without bleeding, pus, or ulcer.
▶️With crying, the protrusions became more obvious..!
⚡️MRI showed lesions 2.9 cm in diameter over the left cheek & 2.7 cm over the right cheek with intact b/l buccinator muscle, presenting high signal in T1-weighted imaging view & low signal in fat-suppression view.
⚡️These were suspected to have extended from the buccal fat pad
Read 11 tweets
A 9-month old girl p/w high grade fevers for 3 days. She has been more irritable but has been eating. This morning, she no longer had a fever but developed a pink blanchable rash over her chest & back. Exam w/ erythematous papules on her soft palate. What is the likely diagnosis?
Roseola infantum @OsmosisMed #pediatrics
Infographic on Roseola Infantum @ambossmed #FOAMed
Read 3 tweets
A 6-YO Bedouin ♂️: a limp, headache, left facial nerve palsy, & left hemiparesis.

Blood eosinophil count of 890/μL.

MRI: a brain cyst.
1/8

DOI: doi.org/10.4269/ajtmh.…
#neurology #pediatric #MedTwitter
Abdominal ultrasound and chest radiography did not reveal additional cysts.
Blood serology (ELISA) for ECHINOCOCCOSIS: ➖

The brain cyst was fully removed surgically.
2/8

DOI: doi.org/10.4269/ajtmh.…
#neuro #Pediatrics #surgery
Histopathological examination of the brain cyst fluid showed several echinococcal larvae (C and D), confirming CYSTIC ECHOCOCCOSIS diagnosis.

Over the following 4 months, he was treated with albendazole without complications.
3/8

#parasitology #microbiology #IDtwitter
Read 8 tweets
Lactante ♀️ de 5 meses: fiebre, síntomas catarrales, buen estado general y lesiones redondeadas, algunas anulares con centro violáceo y otras en diana, algo sobreelevadas, desaparecen parcialmente a la vitropresión y de aspecto indurado
1/6

#pediatría #urgencias #MedEd
El EDEMA HEMORRÁGICO AGUDO DEL LACTANTE afecta a niños entre los 3 meses y los 2 años.
2/6

✍️B Cabezas y col
continuum.aeped.es/screens/play/1… @ContinuumAEP @aepediatria
#AtencionPrimaria #Pediatrics
@ContinuumAEP @aepediatria No tiene afectación sistémica, aunque es frecuente la aparición de fiebre.

Es una entidad benigna y el tratamiento es conservador con resolución entre 1 y 3 semanas
3/6

#IDtwitter #MedTwitter
Read 6 tweets
Child presents with weakness. MR shows enhancement of the pial surface of the conus and ventral cauda equina nerve roots.

#radtwitter #MedTwitter #radres #futureradres #Pediatrics #Neurology @TheASNR @The_ASPNR @AlbanyMedRadRes ImageImageImage
Differential diagnosis:

Leptomeningeal carcinomatosis
Lymphoma
Arachnoiditis (all causes)
Guillain-barre
Neurosarcoidosis
Diagnosis: Guillain-Barré syndrome

These are the typical imaging features for GBS. Contrast is absolutely necessary.

There was no history to suggest systemic sarcoidosis, malignancy, or recent procedure (risk factor for spinal meningitis/arachnoiditis)
Read 3 tweets
A 12-MO♀️ girl, immunization for hepatitis B, 2 weeks prior: a rapidly spreading, nonblanching, nonpalpable, purpuric rash over legs & cheeks surrounded by edema, 37.6°C, nontoxic in appearance

Leukocytosis,⬆️CRP
1/9

#dermatology #Emergency #Pediatrics doi.org/10.1093/cid/ci…
The next day, the hemorrhagic rash became palpable
Pharyngeal PCR:➕for enterovirus
🔬 of purpuric lesions: leukocytoclastic vasculitis, & DI studies showed vascular wall fibrinogen deposition, consistent with ACUTE HEMORRHAGIC EDEMA OF INFANCY (AHEI)
2/9

#pediatric #IDtwitter
Typical patient of ACUTE HEMORRHAGIC EDEMA OF INFANCY:
✔️6–24 months of age,
✔️during winter,
✔️nontoxic presentation,
✔️low-grade fever,
✔️abrupt onset of large purpuric skin lesions,
✔️and edema in face and extremities
3/9

doi.org/10.1093/cid/ci…
#MedTwitter #pediatria
Read 9 tweets
Giving #Paracetamol in cases of mild #Viral #fever may be harmful
1. It is a common practice to give paracetamol (acetaminophen) to children or adults suffering from viral fever. Research evidence shows that we may be causing more harm than good by this practice.
#MedTwitter
2. Fever is not a disease; it is a symptom of viral infection. Paracetamol can not kill the virus.
Acute infections, including those due to Corona virus and other viruses, often stimulate a febrile response.
3. A mild fever appears to improve #outcome; as it diminishes viral replication by several mechanisms, including virion entry into host cells and genome transcription, and improving host defense mechanisms against the pathogen.
Read 6 tweets
A 5-YO♂️ with a history of IgA vasculitis & a pustular nasal lesions had started scabbing after 2 days of systemic glucocorticoids: progressively painful skin ulcerations of L forearm (A), R calf (B) & R foot (C).
1/4

DOI: 10.1056/NEJMicm2204111
#Pediatrics #dermatology
Biopsy samples from all three lesions showed a dense neutrophilic infiltrate with negative tissue cultures.

PYODERMA GANGRENOSUM
2/4

#MedTwitter #Doctor #MedStudentTwitter
Laboratory & radiographic: no signs of underlying systemic disease, such as cancer, inflammatory bowel disease, or autoimmune conditions.

After 8 months of glucocorticoids: the lesions resolved completely.
¾

#resident #pediatric #MedicalStudents
Read 4 tweets
A 17-MO♀️, Morocco: fever, pallor, epistaxis, gingival petechiae, lower limbsedema, & hepatosplenomegaly.

Pancytopenia, hypoalbunemia.
Triglyceridemia, ferritinemia, LDH & fibrinogen:⬆️
PT⬇️
Direct Coombs test:➕

🔬myelogram: ?
1/9

#parasitology #haematology #Pediatrics
Myelogram revealed the presence of leishmania bodies and figures of hemophagocytosis.

VISCERAL LEISHMANIASIS ASSOCIATED WITH MACROPHAGE ACTIVATION SYNDROME
2/9

doi.org/10.1016/j.idcr…
#Pathologists #microbiology #IDtwitter
The patient was put on liposomal amphotericin B and corticosteroid therapy with good clinical and biological evolution.
3/9

#MedTwitter #Doctor
Read 9 tweets
I often get asked “why do kids need the flu shot?”, with the assumption that it’s not that risky for them to get the flu.

Well, have you heard of necrotizing encephalitis? 🧵
#MedTwitter #Pediatrics #neurotwitter
Acute Necrotizing Encephalitis (ANE) is a rare, but fatal complication of influenza infections in children. It presents with all the other symptoms of the flu, but also altered mental status and seizures (which may be difficult to initially distinguish from febrile seizures).
ANE leads to significant cerebral edema and can rapidly lead to cerebral herniation and death.
And for those that recover, less than 10% have complete neurologic recovery.
Image source: DOI:10.1093/cid/cit922 Image
Read 4 tweets
A phrase many of us have used:
"Allogeneic BMT is the only curative treatment for various diseases but associated with morbidity/mortality."

Evidence & local practice are often heterogeneous. Can this year's @ASH_hematology meeting guide us?

🧵with #ASH22 abstracts

#MedTwitter Image
Mini intro to BMT:
-replaces damaged blood or bone marrow cells with healthy ones from donor
-source: peripheral blood or marrow (usually hip)
-matched related, matched unrelated (MUD), mismatched related, mismatched unrelated donors

In that spirit: go register & save lives!
/1 Image
Let's categorize the #ASH22 thread chronologically along the path to and from allogeneic BMT:
-to transplant or not to transplant?
-donors
-conditioning
-graft-versus-host disease (GVHD)
-follow-up
Focus on adults, not a pediatrician. Respect to all in #Pediatrics btw!
/2 Image
Read 16 tweets
👧de 7 años, picadura de #garrapata (fig.) en el sur de #España: febrícula, astenia, múltiples ganglios linfáticos cervicales laterales y posteriores, y escara negra rodeada de eritema en la región occipital (fig.).
1/5

DOI: 10.1016/j.anpedi.2020.03.010
#pediatría #dermatología ImageImage
La niña fue diagnosticada de linfadenopatía transmitida por garrapatas, TIBOLA (TIck-BOrne LymphAdenopathy).

Claritromicina de 5 días: asintomática un mes después. La escara negra desapareció a las 5 semanas.
2/5

#AtenciónPrimaria #urgencias #MedEd
TIBOLA
✔️enfermedad emergente en Europa
✔️causada mayoritariamente por Rickettsia slovaca (también por R. rioja, R. sibirica mongolotimonae, R. massiliae, Bartonella haenselae y Francisella tularensis) y
✔️transmitida por garrapatas Dermacentor

3/5
#microbiología #microbiology
Read 5 tweets
🧒 20 meses, dermatitis atópica: exantema vesiculoso de base eritematosa en región axilar de 3 días de evolución, febrícula e irritabilidad.
1/6

🖊️Bravo B. @ContinuumAEP @aepediatria continuum.aeped.es/courses/info/1…
#pediatria #infecciosas #Medicina Image
@ContinuumAEP @aepediatria El ECCEMA HERPETICUM (o erupción variceliforme de Kaposi):
📌erupción agrupada vesículo-pustulosa sobre base eritematosa
📌el virus del herpes simple reactivado afecta a grandes áreas de la piel
📌en pacientes con dermopatía previa

2/6
#microbiología #Pediatrics #MIR
@ContinuumAEP @aepediatria El eccema herpeticum puede llegar a ser un cuadro grave.

El niño recibió aciclovir oral y evolucionó bien
3/6

#dermatología #pediatric #EducaciónMédica
Read 6 tweets
Pediatric Residency - A First Year Resident's Diary !

Joining Pediatrics ?

Welcome to this world of little wonders! 🌈👶💜
1.Memorize the new normal : To identify what's abnormal one must first know what is the normal range.Vital parameters in pediatric population for instance HR,RR,BP,CRT are very different from what we have been learning for adults.

1/n
2.Identifying a sick child : Perhaps the most important skill for a JR1.
The toxic look,excessive crying/irritability,refusal to feed,grunting,stridor,head bobbing are some of the red flags your seniors will teach you to act promptly at !

2/n
Read 15 tweets

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