Another case for universal PPE in hospital: "recommendations for separations of 3-6' may underestimate distance, timescale, & persistence over which the [respiratory] cloud and its pathogenic payload travel…' jamanetwork.com/journals/jama/…@JAMA_current#COVID19#PPENow
@JAMA_current Also...'A 2020 report from China demonstrated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus particles could be found in the ventilation systems in hospital rooms of patients with COVID-19’ [Are we checking for this?]
@JAMA_current 'For these and other reasons, wearing of appropriate personal protection equipment is vitally important for health care workers caring for patients who may be infected, even if they are farther than 6 feet away from a patient.’ [yes, I agree… until proven otherwise]
@JAMA_current Another uncomfortable point of this article is that we need more information on the efficacy of the masks we are using, including the N95. 'Currently used surgical and N95 masks are not tested for these potential characteristics of respiratory emissions.’ Rapid research needed.
• • •
Missing some Tweet in this thread? You can try to
force a refresh
What we do now is write a paper...& then preprint @medrxivpreprint ...then we take reviews from the journal & the world & work to make the research better. So, Internal tremors & vibrations in long COVID: a cross-sectional study is open for public comment. https://t.co/xh7dXqPcSGmedrxiv.org/content/10.110…
@medrxivpreprint Our objective: 'We compared demographics, socioeconomic characteristics, pre-pandemic comorbidities, & new-onset conditions between people with internal tremors and vibrations as part of their #LongCovid symptoms & people with long COVID but without these symptoms.' #LISTENstudy
@medrxivpreprint Our finding: Among people with long COVID, those with internal tremors and vibrations have more associated symptoms and worse health status, suggesting it may be associated with a severe phenotype of the condition. @YaleCII @YaleMed @YaleCardiology
We have been doing a series of studies, led by @jeb1426, on sex differences in symptom complexity & phenotypes in acute myocardial infarction (AMI) and their impact on diagnosis & treatment. Some imp findings. #Cardiology#MedTwitter@YaleMed@YaleCardiology@yuan_lu1
One of most important articles I’ve done… showing the noise in clinic BP measurement is large & makes it impossible to track Rx effects; almost useless in evaluating change from 2 clinic visits. Let me explain… ahajournals.org/doi/abs/10.116…@YaleMed@YaleCardiology@CircOutcomes
@yuan_lu1@CircOutcomes@SpatzErica@YaleMed@YaleCardiology@AHAScience@amjmed We wrote that persistent hypertension was a condition of repetitive measures of above-goal elevated blood pressure over a period of time (eg, 6 mos), and drug resistance was just one of many causes. And many causes were related to missed opportunities in the care pathways.
Sleep as medicine... On behalf of hospitalized patients, what is we simply stopped ordering routine lab draws before 7am. What is we wrote an order, do not disturb before 7am except for an urgent need. Or an order for 7 hrs of peace and quiet. @FutureDocsnam12.safelinks.protection.outlook.com/?url=https%3A%…
@FutureDocs I strongly believe that rest and sleep are essential to recovery from acute illness...and yet everything we do in the hospital seems to ignore the role of sleep in treatment. We need to put people in a position to help their bodies heal and recovery... not make it more difficult.
@FutureDocs In our study we found it was normal operating procedures to draw bloods from 4-6am on hospitalized patients...the unintended effect, in my view, is to slow recovery and add stress... and impede healing. Shouldn't the hospital be where people can be treated, healed and recover?
@JAMA_current@jeremyfaust@YaleMed@harvardmed@YaleCardiology@EMRES_MGHBWH We believe excess mortality is the best metric of the burden of the pandemic… how many excess deaths compared with a pre-pandemic steady state period. And so not about labeling deaths… but a broader view of mortality.