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💥Dialysis-Associated Steal Syndrome (DASS) occurs in 8% of pts. w/ an AV access
⚡️DASS is most commonly seen with the Brachial artery AV access
⚡️Pathogenesis, Stages and Treatment of DASS is summarized here👇🏽 👇🏽👇🏽
#VascularAccessPearls
#NephPearls ImageImageImageImage
💥Treatment Algorithm for Dialysis-Associated Steal Syndrome 👇🏽 ImageImage
💥Surgical interventions to Rx Steal Syndrome include Ligation, Banding, DRIL, PAI and RUDI
⚡️Ligation results in symptom relief but AV access loss
⚡️Risk of AV access thrombosis vs. symptom relief with other surgical interventions? 👇🏽
#VascularAccessPearls ImageImageImageImage
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More from @aishaikh see all

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Aisha Shaikh
@aishaikh
💥’Dialysis AV Fistula & the Heart:
Friend or Foe?’ - Tweetorial

⚡️Let’s review the following:
☄️Hemodynamic effects of an AVF
☄️Impact of AVF on Cardiac Structure
& Function
1/
 @ASDINNews
@RenalFellowNtwk
#VascularAccessPearls
💥Why is it important to understand the impact of AVF on the heart?
⚡️Because AVF use has ⬆️ in 🇺🇸
⚡️Cardiac disease is highly prevalent among ESRD pts.
⚡️50% of all ESRD deaths are due to
a CV-related cause👇🏽
2/
💥What causes cardiac disease in ESRD patients?
⚡️Many factors contribute to it - as shown below👇🏽
⚡️In this tweetorial, the focus will be on how the AVF affects the heart
3/
Read 20 tweets
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Aisha Shaikh
@aishaikh
💥 Dialysis Access Associated Venous Thoracic Outlet Syndrome (VTOS) is a rare but under-recognized cause of central vein stenosis in dialysis patients
⚡️Tweetorial on Dialysis Access Associated VTOS 👇🏽
1/
 @ASDINNews
@MedTweetorials
#VascularAccessPearls
💥Venous Thoracic Outlet Syndrome
is due to:
⚡️Subclavian Vein stenosis caused by
it’s compression in the thoracic
outlet
⚡️Thoracic outlet is formed by the 1st
Rib, Clavicle & Subclavius
muscle👇🏽
2/
💥 Subclavian vein stenosis due to thoracic outlet compression can occur in healthy individuals & can present with:
⚡️Intermittent positional venous obstruction (McCleery Syndrome)
⚡️Venous thrombosis (Paget-Schroetter Syndrome)
3/
Read 10 tweets
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Aisha Shaikh
@aishaikh
💥Current American Diabetes Association guidelines recommend Metformin as the 1st line therapy for all T2DM patients👇🏽
⚡️But should Metformin be the 1st line therapy in T2DM patients with cardiovascular disease?
1/
 #Metformin
#endotwitter
#cardiotwitter
💥Let’s review the following about
Metformin:

⚡️Mechanism of action
⚡️Safety profile
⚡️Cardiovascular benefits
2/
💥How does Metformin work?

⚡️It inhibits gluconeogenesis in the liver by mitochondrial inhibition & by ⬆️ activation of AMP-kinase👇🏽
⚡️It ⬆️ insulin sensitivity
⚡️It may have additional pleiotropic
effects👇🏽
3/
Read 12 tweets

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Edgar V. Lerma 🇵🇭
@edgarvlermamd
Hemodialysis 101: AVF/ AVG
#Nephpearls #DialysisDirector
Sites for AVF creation in the upper extremity #Nephpearls #NephJC
Various configurations and sites for AVG placement #Nephpearls #DialysisDirector
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Marie-Sophie Adeoso
@madeoso
Ein Thread zum Fall #Wächtersbach, weil mir im Berichten darüber (mal wieder) das weit verbreitete Unvermögen auffällt, rassistische Gewalt klar zu benennen. Typische Formulierungen, die seit gestern immer wieder auftauchen:
1. "fremdenfeindliches Motiv": ich kenne den Inhalt des Abschiedsbriefes nicht, den der Täter hinterlassen hat, mag sein, dass er Hass "auf Fremde" o.ä. formuliert hat. Er hat aber auf jemanden geschossen, den er nicht kannte, von dem er nicht wusste, ob er "fremd" im Land ist.
Konkreter: er hätte auch auf meinen Ehemann oder meine Kinder schießen können, wenn die gestern in Wächtersbach gewesen wären. Die sind Deutsch und Schwarz. Das Motiv heißt also Rassismus, nicht Fremdenfeindlichkeit.
Read 8 tweets
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Matthias Punz
@MatthiasPunz
Der @ORF verbreitet im Hauptabendprogramm nach einem Spielfilm ("Das Wunder von #Wörgl"), den über 600.000 Menschen sahen, in einer Erklär- und Begleitdoku, die haltlose These nach einer "Selbstausschaltung des Parlaments" im Jahr 1933.
Zur Erinnerung: Dollfuß ließ anordnen, dass am 15. März 1933 unter Androhung von Waffengewalt Nationalratsabgeordneten der Zutritt zum Parlament verwehrt wird. Das war das Ende der Ersten Republik in Österreich. Nicht eine kleine Geschäftsordnungskrise davor, die war nur Anlass.
Im Spielfilm selbst wurde auch bewusst der #Austrofaschismus übersprungen. Der Film endet mit der Verurteilung Unterguggenbergs und einer Einblendung, dass er ein Jahr danach starb. Auf einmal hängen schon Hakenkreuzfahnen in Wörgl.
Read 5 tweets
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Peter Morley
@morethanmySLE
Under The Affordable Care Act, Health insurers can NOT charge more or deny coverage to you or your dependents on your insurance b/c of #PreExistingConditions of ANY kind.

Here are the 20 @GOP state AGs & Governors trying to nullify the #ACA

What YOU need to know!

(THREAD) 1/15
Feb.18: 20 States, led by TX, sued, claiming #ACA was illegal:

AL
AR
AZ
FL
GA
IN
KS
LA
ME (Gov. Paul LePage)
MS (Gov. Phil Bryant)
MI
NE
ND
SC
SD
TN
TX
UT
WI
WV

2/15
Lawsuit argues w/o #ACA individual mandate (repealed in 12/17 #TaxBill) the entire law should be illegal! How? Why? What?

In 2012, Chief Justice John Roberts stopped a 2012 lawsuit to make ACA illegal. Roberts said Congress could not order people to buy insurance....BUT

3/15
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Michał Szpakowski
@adwmszpakowski
[Wątek] 1/ na szpagat @prezydentpl trzeba spojrzeć w szerszym kontekście. Prezydent zaniechał dwóch fundamentalnych czynności wprost przyznanych mu w jego ustawie o SN #SN
2/ pierwsza - prezydent powinien wydać postanowienie (art. 142 ust. 2 Konstytucji) stwierdzając przejście w stan spoczynku 10 sędziów. Tymczasem prezydent wysłał listy, w których pisze, że przeszli w stan spoczynku. List nie ma żadnego znaczenia, nie kreuje stanu prawnego.
3/ co ciekawe, listy wysłał również do tych sędziów, którzy powołali się na Konstytucję, wyrażając wolę dalszego urzędowania i nie dołączając zaświadczeń lekarskich. Co ciekawe, takiego listu nie wysłał do PSN Iwulskiego. Ten również stwierdził, że nie dołączy zaśw. lekarskiego.
Read 17 tweets
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JoanneDavis
@JoanneDavis
May 23rd – 2018
Part I – The FISA Court Grants The Authority, Not The Ability…
theconservativetreehouse.com/2018/05/23/par…

1) There is a meeting scheduled tomorrow between key congressional oversight committee heads (Nunes, Gowdy etc.) and leadership of the FBI (Director Wray),
2) DOJ (Edward O’Callaghan) and ODNI (Dan Coats). The meeting was set up by White House Chief of Staff John Kelly, and the purpose of the meeting is to come to some agreement on access to documents being withheld by the DOJ, DOJ-NSD and FBI.
3) However, amid the ongoing debate over spies & informants used by the CIA & FBI to conduct political surveillance, there’s an aspect of the ongoing investigation that seems to be entirely overlooked.

On January 7th, 2016 the Inspector General of the National Security Agency,
Read 25 tweets

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