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1/ I consider #HDL extremely relevant, yes. It’s one of the existing five criteria for metabolic syndrome and one of the three for atherogenic dyslipidemia. ncbi.nlm.nih.gov/pmc/articles/P…
2/ It’s one of my three target markers for the #LCCholesterolChallenge (which is about to turn two years old next week). cholesterolcode.com/lccholesterolc…

I haven’t yet found any study that stratifies ⬆️LDL+⬆️HDL+⬇️TG showing ⬆️cardiovascular disease as of yet, but I’ve found the opposite
3/ See studies linked in this LMHR article - cholesterolcode.com/cholesterol-en…

And I don’t have it handy as I’m on my phone, but we see this likewise stratification of the triad in the 4S trial...
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Dave Feldman
@DaveKeto
1/ Per your question, @lanoie3232 — in watching this video by @ChrisMasterjohn, I’m actually not sure if he’s familiar with my work.

We chatted briefly some years ago and I’m actually a fan of his many great introductions to lipids...
2/ We may have a difference of opinion. I do think one can be average weight or lean, fat-adapted, have very high lipids, and there being normal clearance— and I suspect this is the case with the majority of #LMHRs. (Hence our interest to testing risk via CitizenScienceFoundation.org)
3/ The big tip off in the above scenario is a high NEFA (non-esterified fatty acid) level coupled with a low triglyceride level, which I believe to be suggestive of greater VLDL-TG turnover when alongside a few other key metrics (more on that in the upcoming paper).
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Dave Feldman
@DaveKeto
1/ Thread: The evidence I’m looking for.

One thing that I realized I haven’t taken the time to lay out is the evidence I’ve been searching for — literally since Nov’ 15 when I started this journey:

*Genetically low LDL associating with lower all cause mortality*
2/ That was the most intuitive way to test the lipid hypothesis fully as it would suggest reduction of LDL associating with lower CVD had a net benefit to longevity when compared to the general population.

Genetically less LDL => longer lifespan than overall population
3/ There are many factors I’m particularly interested in that make a study (*any* study) more compelling for me:

(A) Minimal modification. Generally, the less one-off modeling, extrapolating, and unusual exclusions being applied, the more I like it.
Read 13 tweets
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Dave Feldman
@DaveKeto
1/ Wanted to take a moment to express my thanks to @AviBittMD who took some time to chat with me regarding questions I had on the Copenhagen study we were discussing yesterday. Alas, there’s a few different abstracts, but only one published study...
2/ But it’s claim regarding LDL SNPs of PCSK9 vs all cause mortality (ACM) is something I’m very interested in. I don’t know much about the Copenhagen dataset, but assuming it is well collected, the methodology used is clean, and the effect size clear, that would peek my interest
3/ I want to make this clear before having the information in hand for maximum intellectual honestly. Provided there’s no creative methodology or selectivity with the data (preferably complete population, full follow up time possible, etc), then I’d consider this very compelling
Read 4 tweets

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Dr. David Lyness
@Gas_Craic
Today we're going to take a look at BIOENERGETICS in ICU in this quick Tweetorial :-) #ESICMphysio #FOAMed #FOAMcc
Bioenergetics = biochemistry concerned with the energy involved in making and breaking of chemical bonds in the molecules found in biological organisms. It can also be defined as the study of energy relationships and energy transformations and transductions. #ESICMphysio
Mitochondrial functions incl production of energy, activation of programmed cell death, and a number of cell specific tasks, e.g., cell signaling, control of Ca2+ metabolism, and synthesis of a number of important biomolecules. ncbi.nlm.nih.gov/pmc/articles/P…
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Katariina Öörni
@KatiOorni
Did you know that atherosclerotic lesions are acidic?
(1/15)

rdcu.be/bRXph
Extracellular acidity in atherosclerosis is one of my favorite topics, so I'm really, really excited about this study (2/15)
The authors show that some individuals have carotid atherosclerotic lesions that have an acidic pH. They show this is due to activation of Na+-H+ exchanger in macrophages, which leads to extrusion of H+ and extracellular acidification (3/15)
rdcu.be/bRXph
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Sarah Constantin
@s_r_constantin
ncbi.nlm.nih.gov/pmc/articles/P… "Sense of foreshortened future" is a commonly attested symptom of PTSD. Lots of useful concepts in this article.
...the claim that one has died, that part of one has died, or that one persists but no longer “lives:” “I felt as though I’d somehow outlived myself”... “narrative foreclosure,” defined as “the premature conviction that one’s life story has effectively ended...
"there is also what we might call “one-place trust,” where one trusts other people in general rather than trusting a specific individual or group of individuals...one must first have *trust* in order to trust y to do z or to trust y more generally"
Read 16 tweets
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Stan Norred
@StanNorred
This national emergency WALL is a distraction from this socialist/commie legislation of forced vaccination that is not just for kids going to school but EVERY PERSON in America. They can’t wait to poison you. The vaccines contain aborted fetus cells from 12 to 14 week babys...
Here is a color coded vaccine ingredient list from the CDC...
@POTUS
Where is Trump now? All his followers and Q have been saying before this came about that Trump was against forced vaccination. I haven’t heard one word about it from him.
Read 29 tweets
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Aaron Fox, MD
@adfoxMD
Invited as discussant for inpatient medicine case conference.

40yo M w/ persistent asthma & >10 exacerbations past yr

Smoker? No
Environmental exposures? No pests/2nd hand smoke at home
Med adherence? High co-pays, yes

But also resumed intranasal heroin use last yr

[1/17]
Can intranasal heroin use lead to asthma exacerbations?

Yes.

Mechanism may be histamine release w/i respiratory tract & bronchospasm

ncbi.nlm.nih.gov/m/pubmed/12576…
Inpatient mangement asthma unchanged, but in AM, pt tells team “I’m anxious”

Starting to go into opioid withdrawal.

What should we do?
Read 17 tweets

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