Everyone’s awed how Kamala Harris berated Biden saying that she looked “presidential” there is nothing presidential about being ruthless and aggressive in your opposition. So unfortunate to see women in leadership over-assert their strength as a means to dominate #DemDebates2020
Meanwhile male counterparts remained tactful and composed in their opposition. Harris’s ruthless prosecutor record is a testament to the kind of commander in Chief she will be and certainly not the kind we need after a Trump presidency #demdebates2020
Harris’s years as attorney general from 04-11 were spent appealing federal court laws to abolish death penalty, convicting defendants on crimes of rape w/ minimal evidence (sometimes intentionally suppressed) and opposing bills to lower sentence for misdemeanors #demdebates2020
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@MondayNightIBD@DCharabaty 1/ Thiopurines are associated with an increased risk of NMSC (non-melanoma skin cancer)
Which of the following is true about this risk relative to non-exposed IBD pts, duration of thiopurine use , and after thiopurine cessation 🛑#Back2Basics#MondayNightIBD
@MondayNightIBD@DCharabaty 32 y/o M with UC here for f/u. In remission x7 yrs on AZA 75mg/d. He is here to discuss his concerns about his risk of lymphoma associated w/ AZA. (HSTCL= hepatosplenic T cell; EBV-L= EBV assoc lymphoma) Which statement is true? #Back2Basics#MondayNightIBD
@MondayNightIBD@SobiaMujtabaMD@JasonHouMD@DCharabaty 1/ 65 y/o M new dx #Crohns ileitis after he presented w abdo pain,diarrhea, wt loss, anemia. CLN: deep linear ulcers in TI. He has an active lifestyle,stable CAD. Symptoms recur when prednisone<15 mg. What is the LEAST effective strategy to keep this pt in remission? #Back2Basics
@MondayNightIBD@ibdnaik@SobiaMujtabaMD@ibdleuven@DCharabaty 2/ Let’s talk #Crohn’s intestinal complications
CD can present w stricturing/perforating complications
50-60% CD will develop strictures, fistulas or abscesses over time
70% require surgical✂️by 15yrs of dx
Surgery not curative, most pts will have endo recurrence 1 yr post-IC✂️
@MondayNightIBD@SobiaMujtabaMD@NabilQuraishi@CholestasisDoc@DCharabaty 1/ 35 y/o M presents with fatigue & generalized pruritus x 6weeks. No skin rash, No abdo pain, diarrhea or 🩸 in stool. AST 62 ALT 64 ALP 435 Tbili 1.3. MRI/MRCP: multifocal strictures & areas of dilatation of intra +extra hepatic ducts. What’s the next step?💡 #Back2Basics#B2B
@MondayNightIBD@SobiaMujtabaMD@FezaRemziMD@DCharabaty 1/ 35 yo F panUC on IFX 10mg q4wk, admitted with abdo pain, hematochezia, malaise. T 39 BP 95/63 HR 110 FCP 900 mcg/g. Abdo distended, TTP; CT: colonic wall thickening+edematous mucosa. Cdiff neg; WBC 15, Hb 6. No improvement despite IVCS+Abx. Which surgery is indicated #B2BPoll
@MondayNightIBD@SobiaMujtabaMD@SchwartzbergMD@DCharabaty 1/ 27 yo F, crohns colitis on AZA, presents w 2wk perianal pain. One week ago a “boil” developed adjacent to the anus, painful to touch and draining cloudy fluid. PE: Perianal fistulous opening tender & draining pus on palpation. What is the next best step ? #B2B
@MondayNightIBD@SobiaMujtabaMD@SchwartzbergMD@DCharabaty 2/Recap #Crohns:
📌Transmural inflammation involving any part of GIT
📌B for Phenotypes: inflammatory/stricturing/penetrating
📌L for location: UGI,SB,Colon
📌Penetrating Behaviors:
Fistulae
Perforations
Intra-abdominal abscesses(IAA)