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Aisha Shaikh
@aishaikh
, 4 tweets, 2 min read Read on Twitter
💥Teaching point re: Rx of dialysis catheter related bacteremia
⚡️IV antibiotic alone is NEVER the correct Rx choice
Rx options are:
☄️IV antibiotic + CVC antibiotic
lock solution
OR
☄️IV antibiotic + CVC exchange
@ASDINNews
#VascularAccessPearls
1/
💥The reason IV antibiotic alone is not the correct choice is because it does not eradicate the bacteria in the CVC lumen biofilm
⚡️For effective clearance of bacteria from the biofilm you have to use CVC antibiotic lock solution or exchange the CVC
2/
💥The choice of antibiotic for catheter related bacteremia is listed below👇🏽
⚡️How to prepare the CVC antibiotic lock solution?👇🏽
@RenalFellowNtwk
3/
💥CVC has to be removed in the setting of:
☄️Sepsis, hemodynamic instability
☄️Tunnel/ exit site infection
☄️Persistent fever after 48-72 hrs. of adequate antibiotic therapy
☄️Resistant pathogens (eg. MRSA, fungal infection) 👇🏽
4/
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More from @aishaikh see all

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Aisha Shaikh
@aishaikh
💥’Physical Examination of the Dialysis Vascular Access’ - Tweetorial

Let’s first review the:
⚡️Anatomy of the Vascular Access
⚡️Vascular Access-related
complications
1/
@ASDINNews
@RenalFellowNtwk
#VascularAccessPearls
💥 A dialysis vascular access is a ‘circuit’ and NOT just a ‘connection’ between an artery & a vein

⚡️The circuit consists of:
☄️ Pump (heart)
☄️ Inflow (artery)
☄️ Conduit (body of the access)
☄️ Outflow (vein)
2/
💥 There are 3 basic types of vascular access:
⚡️AVF (arterio-venous fistula)
⚡️AVG (arterio-venous graft)
⚡️CVC (central venous catheter)

☄️AVF: created by a direct connection b/w an artery & a vein
☄️AVG: graft is interposed b/w an artery & a vein👇🏽
3/
Read 19 tweets
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Aisha Shaikh
@aishaikh
💥HeRO Graft Tweetorial

⚡️’HeRO’ stands for ‘Hemodialysis
Reliable Outflow’
⚡️What Nephrologists need to know
about HeRO👇🏽
⚡️HeRO graft: Indications, Outcomes
& Complications
1/
 @ASDINNews
@SocietyAccess
@RenalFellowNtwk
#HeRO
💥What is a HeRO Graft?

⚡️It is half graft + half catheter
⚡️Fully Subcutaneous

⚡️Graft-component is connected to the artery at one end & to the catheter at the other end

⚡️Catheter-component serves as venous outflow w/ it’s tip @ SVC/R. atrium
2/
💥Is any part of the HeRO graft exposed externally?
⚡️No

⚡️Graft-part is subcutaneous just like the conventional AVG

⚡️Catheter-part traverses the central veins BUT instead of sticking out through the skin it connects subcutaneously w/ the graft👇🏽
3/
Read 21 tweets
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Aisha Shaikh
@aishaikh
💥 Hydroxychloroquine - is an
Anti-malarial drug that also has immunomodulatory properties
⚡️It is used to Rx auto-immune conditions
⚡️The origin and history of this drug is as fascinating as it’s benefits
1/
 @RenalFellowNtwk
#Lupus
#medtwitter
💥 Quinine was 1st found in the bark of the ‘Cinchona’ tree by the Inca in Peru to Rx ‘shivering’
⚡️It is believed that the tree got its name ‘Cinchona’ after it was used to treat the ‘Countess of Chinchon’ for a febrile illness in the 1630s
2/
💥 In the early days, the Cinchona bark tree powder was called the ‘Jesuits Powder’ (and not Quinine)
⚡️However, this 👆🏽is why side effects from quinine - such as tinnitus, headaches and poor vision are referred to as ‘Cinchonism’
3/
Read 19 tweets

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RedQueenRedTeam
@RedQRedT
Please RT! 12-tweet #teaching topic "When #Military #History was changed by the #environment" - all eras welcome!
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cc @stuffofwar @SMH_Historians @WarintheFuture @Army_Leadership @madpadre1
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Alex Wickham
@alexwickham
EXC: White supremacists discussed killing MEPs in a private forum used by UKIP candidate Sargon of Akkad to run his Euro election campaign

They also praised the Christchurch mosque terrorist and talked about hanging black people and Jews

buzzfeed.com/markdistefano/…
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RyuZoku
@Ryu_Zoku
There are many forms of computing hardware systems, ever more so these days with TPU (Tensor Processing Units), GPUs, Multi-Core CPUs, Parallela Epiphany cores, FPGAs, Risc-V ISA, Analog Computing, Quantum Bits, Memristors, AI, ML, Deep Neural Nets, ...

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Prashant Mullick
@VohiCapital
Selling puts unnecessarily scares a lot of options traders.

If done correctly, selling cash secured or slightly levered puts is one of the most lucrative and simplest of options trading strategies.

A thread on Cash Secured Put selling.

(1/n)
The value of puts is derived from what the marketplace assumes is downside risk of any underlying.

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(2/n)
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The equity premium is simply the premium you get paid for holding the stock for long periods of time.

Puts marry these together.

(3/n)
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Prashant Mullick
@VohiCapital
The God of #Options #Greeks is often disregarded and has no mercy, especially on #Options #expiration day.

A #Thread on #Gamma.

#OptionsGreeks
1/n
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Most traders understand that #OptionsPricing is dependent on the price of the underlying, but the response is non-linear. #Gamma is the variable that describes this non-linearity.

#OptionsGreeks
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#OptionsGreeks
3/n
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Andrew Ruis
@AndrewRuis
I recently talked with graduate students in a seminar on #teaching practices in #HigherEducation about how to design and teach a course when you are not an expert on all of the content--which is really what most teaching is. Here are the main takeaways for those interested. 1/
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