Discover and read the best of Twitter Threads about #steroids

Most recents (13)

It’s been a busy couple of nights in the ICU. Normally I’d be asleep right now, but I’m pumped to talk about #steroids in #COVID19.

A Brief Thread on #steroids in #COVID19.

(Spoiler alert: more compelling RCTs show that steroids work!)
1/
Early in the pandemic it was unclear if steroids would be beneficial or harmful.

There were studies that steroids could reduce mortality in ARDS (DEXA-ARDS), but also studies showing that they could prolong viral shedding in related viruses (MERS).

Clear equipoise for RCTs.
2/
This changed in June, when the #RECOVERY trial (bit.ly/2QKCSGJ) found an impressive mortality decrease in patients treated with #dexamethasone.

This large, well designed study almost immediately changed practice. But a few questions lingered..

3/
Read 12 tweets
Some fcukin bastards do not deserve ANY mercy. They take our money, our taxes and build bungalows for themselves, YES I am looking at your #Matoshri. They travel in range rovers (hi AU) while ppl in #Mumbai get crushed in trains. They drink in 5 star bars while bridges ..
fall on their damn heads. They pollute #Mumbai with hard drugs (not talking about weed) but #meth, #cocaine, #LSD, #MDMA and ruin our youth through it. They can bring in ‘maal’ from #Malaysia, #Nepal, #Afghanistan but cannot feed the poor on the streets in the city. They run..
over homeless ppl sleeping on streets and then make bakchod movies & shows like #Tubelight & #BiggBoss14 and we are expected to pay to watch that shit. They pay #ViralBhayani & #ManavManglani etc to take photos of #Diwali parties with their wives but don’t tell you about how ..
Read 12 tweets
10 common ways men damage their sperm without knowing

1. Tight underwears
2. Hot baths
3. Infections
4. Varicoceles
5. Laptops
6. Drugs
7. Mobile phones
8. Smoking
9. Marijuana
10. Steroids

A thread 🧵

{Share to who needs this!}
1
Wear boxers instead of tight pants, & go to bed naked if you want to become a father.

Wearing tight #underwears like pants or shorts keep your testicles closer to the body, leading to warmer temperatures that may kill sperm & lower sperm count.
2
Bathing with #hotwater frequently exposes your testicles to heat, which reduces your sperm count.

Same thing happens to men who use saunas often.

In fact, if you're worried about infertility, it's best to bath with cold water.

Avoid hot water baths!
Read 15 tweets
Posting some reflections on the #ACTT & #RECOVERY trials related to #remdesivir & #dexamethasone for the treatment of #COVID19

Those results feel like definitive advances, but we need to realize their limitations and need for confirmation despite everyone's #pandemic fatigue

1/ Image
There are lot of skeptics in and outside of #Twitter on the results of both trials, strong emotions regarding big-pharma made medications, the way the #EUA was made, also about use of #steroids in the #ICU that has a quite rocky history among those who run those units.
And we need to acknowledge from the outset all sorts of basic, and not so basic, emotions that come in the doing clinical trials, exacerbated by academic cliques, national defense issues (and nationalisms) that can get exacerbated with the strains in health systems. Image
Read 21 tweets
Tabulated the topline results released by the #recoverytrial team on #hydroxychloroquine & #dexamethasone, and went over their protocol (recoverytrial.net/results) to better digest them.

Basic stuff:
- hospitalized patients @ 175 NHS centres
- open label, 5 initial arms
- thread—
Important point from #RECOVERYTrial protocol

- if a patient had a #contraindication to one of the intervention arms, according to the clinical care team at the site, that particular arm was not available to that patient at the time of #randomization
So if a patient enrolled in #recoverytrial had a contraindication to #dexamethasone, that patient was not allowed to be randomized to that arm. So the results need to be interpreted in the context of no contraindication to steroids: already on steroids, #immunosuppression, etc.
Read 11 tweets
A #practical topic for today. #Pregnancy changes things - but more so for our #neurology patients - or not? #pearls from the #EAN2020 #MedEd #MedTwitter #MedStudentTwitter #neurologyresident @EANeurology @WNGtweets
Let’s first address #multiplesclerosis. Patients get better in third trimester and 30% relapse #postpartum. Immune responses shifts to anti-inflammatory in 3rd trimester to accommodate fetus - #etcomehome - but rebounds after birth. #MedEd #doubledoc #AcademicTwitter
Continue #firstlineinjectables #glatiramer and #interferon - these don’t cause #teratogenicity. In flares, consider IVIG and PLEX. How about #steroids? Usually fine except in 1st trimester when they can cause birth defects #MedEd #MedStudentTwitter #MedTwitter
Read 6 tweets
Let’s do a quick one on #clinicaldecisionmaking and #neuroimaging. See bright spot on MRI T2 Brain just means increased water -could be any insult to the brain - #infection #inflammation #ischemia #neoplasm are the top 4 you gotta have in your brain. Pun intended. #MedTwitter
Then you think - active or inactive process? If it’s actively destroying the BBB, it’ll enhance on contrast enhancement. So get MRI with and without contrast. Why without? T2 shine-through - but that’s for another time. #MedStudentTwitter #neurology #neurologyresident
Now the important question here is what you do - remember that nice poem on #theroadnottaken by #robertfrost? 2 widely diverging choices - to immunosuppress or not to immunosuppress. #tobeornottobe #hamlet #MedTwitter #AcademicTwitter #MedStudentChat
Read 13 tweets
Starting a series on clinical Pearls I am gathering in #COVID19 patients based on experiences of many experts

Will add as we go along

Feel free to add your own observations/experiences

#covidclinicalpearls /1
Anosmia is likely the most specific #COVID19 related symptom
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
Around 90% of patients have fever.
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients

#covidclinicalpearls /3
Read 66 tweets
Today, our IBDLIVE program focused on #COVID19, with >25sites & >200 participants from across the 🇺🇸Great discussion on how it impacts our patients w/ #IBD. @MRegueiroMD @ConorDelaneyMD @IBD_FloMD @BenClickMD @tqaziMD @ScottRSteeleMD @drtracyhull @HolubarStefan @AmyLightnerMD
1/
Here is a #tweetorial with selected slides from the presentation
Although the main mode of transmission seems to be through droplets, #SARSCoV2 can be found in stool and in gastrointestinal glandular epithelial cells, raising the possibility of fecal-oral transmission 2/
Here are outcomes among inpatients with #COVID19 based on available data. Mortality rates are higher in older patients and in patients with comorbidities
3/
Read 10 tweets
#Therapist asked me to do a #Trauma timeline. Holy shit was that tough.
Long thread. 2006-Find out we can’t have baby. #fertility treatment, fertility shots, fertility drugs. Father in law cheats on/leaves mother in law. Start youth therapy group (1/11)
2007- Egg harvest. Only 1 egg survives #fertilization process. Implant. Wife to ER twice. #Preeclampsia. Placed on Bed Rest.
2008-Derek born 1 month early. #NICU . Wife suffers #postpartum. Derek hospitalized for 1 week due to illness. (2/11)
2009-I get Shakes, stuttering & severe pain. Diagnosed with #GravesDisease Buy a house. Take in 18 year old niece with #addiction/#behavior issues. I have radiation therapy to remove thyroid (3/11)
Read 11 tweets
It’s #Monday, I’m boozing it up at a 4 seat bar, the #barkeep is a long pourer, and I’m all fucking set if I get something stuck between my teeth.👇🙃 #RandomThoughts #drinking #OutAndAbout
Shooting the shit with a friend, she’s proud to be doing well with her plants - unusual for her.

The key was a #video explaining the benefits of pruning.

She needs REASONS. She got them.

Apparently, pruning in a particular manner stimulates growth hormones.
#RandomThoughts
Of course, this led to me initiating a discussion about the #movie I just watched on Hulu, called “The German Doctor.”

The main character was Josef Mengele. #ThisHappened

People, this is why I’m known in my circles as “The Black Hole Of Conversation.” SMTH
#RandomThoughts
Read 239 tweets

Related hashtags

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!