Discover and read the best of Twitter Threads about #tweetorial

Most recents (24)

Do cyclin-dependent kinase (CDK) 4/6 inhibitors cause acute kidney injury (AKI)? #onconephrology #Thread

A little #tweetorial about CDK 4/6 inhibitor-associated AKI: what we know already, and what we found
kireports.org/article/S2468-…
3 CDK 4/6 inhibitors (palbociclib, ribociclib, and abemaciclib)have been approved for HER2-negative metastatic breast cancers. CDK 4/6 inhibitors help overcome resistance to endocrine therapies by preventing cell-cycle progression and cancer growth (frontiersin.org/articles/10.33…).
What do we know about AKI related to CDK 4/6 inhibition? In vitro studies suggest that CDK 4/6 inhibitor metabolites inhibit renal transporters, potentially leading to a reversible rise in serum creatinine (SCr) without actually changing GFR (ncbi.nlm.nih.gov/pmc/articles/P…).
Read 10 tweets
1/
Nephrology:
“We will forever argue about validity of equations to convert serum creatinine to eGFR using age, sex etc”

Also nephrology:
“We will make no adjustment for muscle mass when using urinary creatinine within urine ACR”

A #tweetorial on two albuminuria paradoxes 👇
2/
Recap: why use early morning urine ACR?

✅Correlates well with ‘gold standard’ 24hr urine collection (pain to perform)

✅Creatinine in denominator corrects for urine dilution - works when creat excretion constant (but, note some daily variation)

ncbi.nlm.nih.gov/pmc/articles/P…
3/
Albuminuria quantification is useful prognostically (as well as clear diagnostic utility!):
❗️Independent risk factor for CV mortality
❗️ RENAAL showed higher uACR = higher risk of CKD progression in patients with type 2 diabetes

pubmed.ncbi.nlm.nih.gov/15302780/
Read 20 tweets
1/

🚨Delighted to do a quick #tweetorial on our short report in the💚#GreenJournal @RadiotherapyOn1

☢️Heterogeneous immunogenicity of SARS-CoV-2 vaccines in #cancer patients receiving
#radiotherapy💉

➡️thegreenjournal.com/article/S0167-…

#radonc #COVID19 #CovidVaccine #lcsm
#OncoAlert
2/

Inspired by:

[Our patients]
Doctor, is the #radiotherapy I am getting affecting how well my #CovidVaccine works?

[Us]
🤷
3/

There is large heterogeneity when looking at immunogenicity of #COVID19 vaccines in #cancer patients & esp #lungcancer patients shown by @vivek_naranbhai & team in @JCO_ASCO

Chemo may suppress antibody levels somewhat.
What about #radiotherapy?

➡️ascopubs.org/doi/pdf/10.120…
Read 8 tweets
Wir haben ein neues Tweetorial für euch!🙌 Diesmal beschäftigen wir uns mit der „Laktatdialyse“. Damit ist eine Dialyse gemeint, die das Ziel hat, Laktat aus dem Blut zu entfernen um so auch vermeintlich eine Laktatazidose auszugleichen. Langer 🧵, aber lohnt! 1/15 #tweetorial
Zugrunde liegen die Vorstellungen, dass Laktat ein Toxin ist und es eine Azidose direkt unterhält. Eins vorweg: Dass Laktat nur ein Marker für die "Kritischheit" einer Erkrankung ist und kein Toxin, also selbst nicht die Krankheit unterhält, sollte schonmal klar sein ‼️. 2/15
Damit bleibt als Rationale für die Laktatdialyse nur der erhoffte Effekt auf die Laktatazidose. Unsere Lernziele🎯: Kann Laktat (relevant) dialyisiert werden? Wenn ja, hat dies einen Einfluss auf den pH? Warum ist Laktatazidose ein irreführender Begriff? 3/15
Read 15 tweets
1/
It was a delight to work with @gabifpucci of @neudrawlogy to explore the incredibly diverse CNS complications of infective endocarditis!

An #infographic & #tweetorial investigating the radiographic & clinical findings in IE + some management pearls!
#MedEd #Neurotwitter
The most common cause of neurologic injury in IE is ischemic stroke.
But! Management is somewhat different.

Notably, due to the high risk of hemorrhagic transformation, tPA is relatively contraindicated or should be used with extreme caution.

You don’t want to end up with ⬇️!
3/
As evidence: in this series, 1 in 5 patients experienced post-tPA ICH and only 10% achieved a good outcome.

Thrombolysis for Ischemic Stroke Associated With Infective Endocarditis ahajournals.org/doi/full/10.11…
Read 13 tweets
1/
Join me for a #dermtwitter #tweetorial on:

SCARS AND KELOIDS!

#MedEd #FOAMEd #medstudenttwitter #MedTwitter

Let's start ourselves off with a question: Which one of the following conditions will lead to scarring?
2/
The correct answer is Pyoderma Gangrenosum! This illustrates a quick first point - scarring only occurs if you damage the skin into dermis and beyond. Epidermal damage heals without scarring, which is why the first 3 don't lead to scarring!
3/
So what exactly is a scar?

Scarring is a normal part of healing that at its root, is extra collagen laid down to repair skin injury.

However, sometimes the process gets out of hand and exuberant which leads to hypertrophic scars (pic 1) keloids (pic 2)!
Read 12 tweets
The new epidemic: ATTR Cardiac #Amyloidosis: Current and Emerging Treatment Strategies

Follow/share this #JACCCardioOnc #Tweetorial!

🧵 1/
ATTR cardiac #amyloidosis: Tip of the iceberg - current and emerging therapies to manage and prevent #heartfailure.

#JACCCardioOnc #CardioOnc

2/
ATTR #amyloidosis: Clinical progression and management strategies 👇

#JACCCardioOnc #CardioOnc

3/
Read 5 tweets
Watch here TOMORROW for a new accredited, #tweetorial by neurointensivist @stephanamayer on optimizing DAPT and other interventions for secondary stroke prevention after #AIS or #TIA. Earn 0.5 CE/#CME credits: #physicians, #nurses, #pharmacists! #NoMercyOnStroke @svinsociety
1) Welcome to a #tweetorial on how to optimize therapy for secondary #stroke prevention. Accredited for 0.50 credits! I am your host @stephanamayer. Be sure to see prior tweetorials in the broader cardiometabolic space and earn more CE/#CME credit at cardiometabolic-ce.com Image
Read 54 tweets
Be sure to join us TOMORROW here on @ckd_ce for our first ORIGINAL accredited content . . . from none other than @edgarvlermamd . . . whom you #kidney-oriented clinicians will know as a comforting and familiar presence and as an AWESOME teacher. He'll be talking about ...
...IgA nephropathy (#IgAN) from the ... perspective of the 2021 @goKDIGO #guidelines. Lots to learn about this common cause of #CKD worldwide! Free CE/#CME for #physicians #nurses #PAsDoThat #nursepractitioner @ANNAnurses @neph_PAs @pharmacists @nephondemand @IgAN_JBarratt
Read 35 tweets
1/🧵
Ever wonder why cutting onions makes you cry?

Something must be released that causes this irritating response, but what?

It turns out that cutting an onion jumpstarts multiple chemical reactions, in the air and right in front of your eyes.

#medtwitter #tweetorial 🧅
2/
💡Onions are actually one of the oldest cultivated crops, first entering the human diet ~5,000-7,000 years ago.

Ancient Egyptians worshipped onions (evoked eternity) and ancient Indians, Greeks, and Romans believed that they had medicinal properties.

onions-usa.org/all-about-onio…
3/
But as anyone who has ever cut or chopped an onion knows, the simple act of chopping them causes almost immediate eye irritation and tearing.

Why?
Read 17 tweets
1/24 This month’s #EHJCaseReports #tweetorial focuses on percutaneous left atrial appendage occlusion.

Is #LAAO the exact solution for preventing stroke & embolism in #AF pts who can’t tolerate #OAC?
Or, a new problem while seeking a solution?
doi.org/10.1093/ehjcr/…
#CardioEd
2/24
🎯 The rationale of #LAAO
🔸 In non-valvular #AF patients, 90% of thrombus is located in the #LAA
🔸 These thrombi embolise to the 🧠 & cause #stroke
🎯 Don't miss the ‘#EHRA_ESC #EAPCI expert consensus document on catheter-based #LAAO –an update’ doi.org/10.1093/europa…
3/24
#LAA closure devices should be safe, efficent and easy to deploy.

📌 Currently available catheter-based devices for #LAAO have different principles.

A- Plug ➡️ Watchman
B- Pacifier ➡️ Amplatzer Amulet
C- Ligation ➡️ Lariat

doi.org/10.1093/europa…
Read 25 tweets
1/ #tweetorial
⮞Optic disc edema vs. Papilledema
⮞Orbital anatomy
⮞Orbital #POCUS
2/ First what is 𝗽𝗮𝗽𝗶𝗹𝗹𝗲𝗱𝗲𝗺𝗮?

𝘐 𝘸𝘪𝘴𝘩 𝘐 𝘤𝘰𝘶𝘭𝘥 𝘨𝘦𝘵 𝘪𝘮𝘢𝘨𝘦𝘴 𝘭𝘪𝘬𝘦 𝘵𝘩𝘦𝘴𝘦...
[source bit.ly/3yceeCT]
3/ 𝗢𝗽𝘁𝗶𝗰 𝗱𝗶𝘀𝗰 𝗲𝗱𝗲𝗺𝗮 = optic nerve head edema + anterior bulging of physiologic cup

𝗣𝗮𝗽𝗶𝗹𝗹𝗲𝗱𝗲𝗺𝗮 is optic disc edema 𝙙𝙪𝙚 to 🡱intracranial pressure

**𝗡𝗼𝘁 𝗮𝗹𝗹 𝗼𝗽𝘁𝗶𝗰 𝗱𝗶𝘀𝗰 𝗲𝗱𝗲𝗺𝗮 𝗶𝘀 𝗽𝗮𝗽𝗶𝗹𝗹𝗲𝗱𝗲𝗺𝗮 [bit.ly/3wEIUwG]
Read 13 tweets
Don’t miss a new accredited #tweetorial launching TOMORROW here on @cardiomet_CE. #Cardiologist, #SoMe education advocate, and true #Renaissance man @CMichaelGibson will be discussing a novel #aspirin prep that has PK/PD like plain #ASA . . .
. . . but a different site of absorption--with greater predictability than ECASA. DON'T MISS IT!! @DLBHATTMD @cpcannon @AnnMarieNavar @DrM_ODonoghue @DrMarthaGulati @practicalcardio @GuyattGH @DrMauricioCohen @SVRaoMD @ASPCardio @PlateletDoc @stephanamayer #FOAMed #CardioTwitter
1) Welcome to a #tweetorial where we’ll explore how changing the formulation of #aspirin & where it's absorbed in the GI tract can ⬇️the risk of acute GI injury, but still maintain predictable absorption. This program is accredited for 0.50h CE/#CME. I am @CMichaelGibson. #FOAMed Image
Read 42 tweets
1/
Hi #dermtwitter/#medtwitter! Our last (for now!) #tweetorial/#medthread on nails! This time it’s...

PEDIATRIC NAIL CONDITIONS!

Education from @naildisorders and the @jmervak team!

@societypedsderm @PeDRAResearch #medstudenttwitter #medtwitter #meded #FOAMed
2/
Beau’s lines (transverse ridge) and onychomadesis (nail shedding) common in kids! Often seen in a post-viral setting.

Common culprit = hand foot mouth disease!
3/
Congenital malalignment of the great toenails – lateral deviation of the first toenails. More common than you think. Start looking at more toes and you’ll see it! Can improve with time or persist. Risk for nail thickening or ingrown nails.

pc: sciencedirect.com/science/articl…
Read 12 tweets
1/
It’s no secret what’s growing in blood.
But, the cultures won’t clear,
On valves it adheres!

Patient aphasic,
What’s with the agitation?

ESR & CRP rising!
An #Tweetorial advising:
Never overlook the spinal epidural abscess!!

#EmoryNCCTweetorials
2/
All poetry aside (pretty good tho, right?!)

Goals for the scroll (⬅️credit @sigman_md 😂):
1⃣ How difficult it can be to diagnose spiral epidural abscesses (SEA)
2⃣ What exactly is the spinal epidural space
3⃣ How these should be treated
4⃣ And why decompress?
3/
Diagnosing SEA = super tricky. The symptoms & labs are so non-specific!
✅Back pain ⏫(but back pain--who doesn't?)
✅Fever is often present, but not always.
✅WBC may be elevated, but sometimes just mildly. ✅Blood cultures are only positive about 60% of the time.
Read 21 tweets
I feel like it's “time” for a shoddily-organized scratching-the-surface #neuropsychtwitter #tweetorial on clock drawing in dementia. 1/x
I will focus on the most common (or arguably best) version of the clock drawing test (CDT): command (free) drawing of a “10 after 11” clock followed by copy of a clock stimulus. 2/x
The first documented use of CDT was by Sir Henry Head. Per Hazan et al. 2017: “Head's reasoning behind using the clock tests was that they required the execution of meaningful speech, an almost impossible task for people with aphasia.” 3/x bit.ly/3mJDVrb
Read 18 tweets
Time for a #CriticalCare #Tweetorial!

‼️Basics of CRRT for the non-nephrologist‼️

Exiting my typical #Neurology wheelhouse as I tackle some #FOAMcc topics for my own learning. Please join in on teaching and address any mistakes!

#EmoryNCCTweetorials
@EmoryNephrology
1/🧵
CRRT- What does it stand for?!

Continuous- Runs around the clock (sort of)
Renal- The beans!
Replacement- More of a rinse than a true replacement
Therapy- It helps!

@criticalbeansmd @EmoryNeuroCrit @caseyalbin @KrafteKraft4 @mallyaa @VijayanMD
2/🧵
Why do we use CRRT instead of HD?

Patient’s with hemodynamic instability (ie blood pressure is so low they can’t tolerate HD)

Conditions where you need to avoid large fluid shifts (like cerebral edema)

3/🧵
Read 21 tweets
#tweetorial 🧵
🚩AL & MM - Transcriptional patterns link common causal root with differing behaviours
(1/14)
➡️Light-chain amyloidosis (AL) and multiple myeloma (MM), are plasma cell (PC) malignancies with strikingly different clinical presentations 🥼🩺
➡️Success in🎯identifying these mechanisms has thus far been limited 👎
(2/14)
➡️Alameda et al define a “transcriptional atlas” of normal PCs, AL amyloidosis, MM, and MGUS, identifying 13 different transcriptional patterns linking distinct PC dyscrasias to subsets of normal developing PCs, with diagnostic 🔬and prognostic implications
Read 19 tweets
1/
A #tweetorial about simulation in NCC
Today @namorris opened his remarks on Sim in NCC @ #NCS2021 w/ a simple question about the correct first line treatment for SE? Everyone got it.

Then he posed a tougher question.

How often does that happen?

No one voted "always"
2/
Even the most groundbreaking research won’t benefit our patients if we aren’t delivering it correctly.

I so highly encourage you to check out Nick’s talk on-demand if you have access to #NCS2021.

It is 🚨critical🚨 that we teach more effectively!
3/
Convinced?

Some practical, take-aways from this talk about finding right Simulation Solution. Image
Read 19 tweets
So you got major revisions - congratulations!
Below is a step-by-step guide to submitting a revised manuscript to a clinical journal
There are nuances but it's a relatively standard formula for most journals
I hope you find this 🧵 helpful!
#MedEd #tweetorial #MedTwitter 1/20
Copy and paste all comments from the email into a word doc. This is your 'response letter'.
Number each comment, by reviewer or sequentially.
Leave spaces to fill in your responses to each comment.
Format so their comments can be easily distinguished from your responses. 2/20
Examples in pic - many options.
Don’t rely on different font colour b/c when you cut and paste it into ‘response’ box, it will all be black.
Red ink has negative connotations and everything else seems weird. Italics makes it hard to read.
Underlining comments also ok. 3/20
Read 20 tweets
1/
Join me for a quick #tweetorial/#medthread on:

Pearls for the #Dermatology Exam!

#MedEd #dermtwitter #medtwitter #medstudenttwitter #FOAMed

First a question - What do you think when someone asks for your help with a rash?
2/
Regardless how you answered, I hope to teach you something today! Let's start!

"In #dermatology, we don't do an H+P, we do a P+H."

The exam is perhaps most important. You can use it to narrow down your ddx! Then, you use your history to further work toward the right dx.
3/
"If there's scale, there probably is epidermal involvement."

Scale usually implies action in the epidermis. This doesn't rule out anything in the dermis or subcutis, but just that the pathology includes action up top.

Check out my #tweetorial on scale
Read 10 tweets
1/11
Time for a #tweetorial on one of my favorite topics: Wrist Drop. @AANMember @NMatch2022 #neurology #futureneurologist #neurotwitter #neurotwitternetwork @AANEMorg #meded @KoriPoRodri

The first thing you should think of when you see a patient with weak wrist extension is…
2/11
This. Compression of the radial nerve at spiral groove. And usually, we think of it as being caused by... Image
3/11
This. And by the way, if you’re ever curious about the surprising origins of the term “Saturday Night Palsy,” read this article. pubmed.ncbi.nlm.nih.gov/12188953/

But I digress. The spiral groove (aka radial groove) is not the only peripheral localization for wrist drop. Image
Read 11 tweets
1/
Hi #dermtwitter! Back for another #tweetorial/#medthread on nails! Today we’re learning about:

ONYCHOMYCOSIS- nail fungus!
 
This is THE most common nail condition- so follow along!
Education from @naildisorders
#medstudenttwitter #medtwitter #meded #FOAMed
2/
Onychomycosis is more common in adults than kids.
Trauma, diabetes, immunosuppression, tinea pedis, psoriasis, and family history are some risk factors

Pro tip- check the feet for tinea pedis if you suspect onychomycosis!

@podiatrytoday
3/
Patients with onychomycosis present with nail discoloration (yellow to brown), onycholysis (nail separation), nail brittleness, or nail thickening.

The big toenail is most frequently affected.

Fingernail involvement without also have toenail involvement is uncommon.
Read 14 tweets
1/ “Let’s hear about this patient at the bedside.”

As an educator or learner, does this sentence make you tachycardic??

It’s another #TweetorialTuesday from the @MedEdTwagTeam! #MedTwitter #MedEd #MedStudentTwitter #Tweetorial #FacDev
2/ We are still covering the foundations of inpatient teaching.

This week, we will focus on general strategies to incorporate bedside teaching effectively into your inpatient teaching tool box!
3/ First, there are many benefits to teaching @ the bedside for learners, educators, & patients alike.

See articles:
⚡️@DanielRicottaMD TWDFNR @JHospMedicine: tiny.cc/RoundsTWDFNR

⚡️@OlleTenCate Review on Bedside Teaching / tinyurl.com/BedsideReview
Read 15 tweets

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