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@aknappjr @lewistlc @csentropy @farid__jalali @BioBreakout @Pharmaheretic @medusimal Hyaline membrane formation already suffices to begin impairing gas exchange on epithelial side even in advance of endothelial dysfunction and partial occlusion within microvasculature--

medicinenet.com/script/main/ar…
lay source but decent

Impairment on both sides of alveolar wall.
@aknappjr @lewistlc @csentropy @farid__jalali @BioBreakout @Pharmaheretic @medusimal Matches earlier suspicions on accumulation of debris, lack of surfactant


ACE2 expressed most heavily within lungs by goblet cells, ciliated cells.

Virus kills them selectively, lysate accumulates, hyaline membrane forms. Beginning of 'silent hypoxemia'.
@aknappjr @lewistlc @csentropy @farid__jalali @BioBreakout @Pharmaheretic @medusimal @cameronks I think we may have some answers for your observations re: silent hypoxemia
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ice9
@__ice9
@DmclDoc @lewistlc @Pharmaheretic @medusimal @farid__jalali @__philipn__ @BioBreakout @aknappjr @sm0b0t Severe inflammation may increase mitochondrial oxidative stress
sciencedirect.com/science/articl…

Hypoxia in occluded regions likely exacerbates
ncbi.nlm.nih.gov/pubmed/29601945

Glycolysis increases
ncbi.nlm.nih.gov/pmc/articles/P…

PPP should slow in hypoxia (caveat: cancer paper)
ncbi.nlm.nih.gov/pubmed/24005892
@DmclDoc @lewistlc @Pharmaheretic @medusimal @farid__jalali @__philipn__ @BioBreakout @aknappjr @sm0b0t Ascorbate is depleted by hypoxia.
ncbi.nlm.nih.gov/pubmed/9128902

Ascorbate mitigates some effects of hypoxia.
physoc.onlinelibrary.wiley.com/doi/pdf/10.111…
ncbi.nlm.nih.gov/pmc/articles/P…
The IV vitamin C cancer people may have a point tbh, supportive anyway.

Likely helps here as well:
@DmclDoc @lewistlc @Pharmaheretic @medusimal @farid__jalali @__philipn__ @BioBreakout @aknappjr @sm0b0t Not sure how far ascorbate must fall for RBC fragility, but can do in vivo; makes spherocytes
ncbi.nlm.nih.gov/pmc/articles/P…

Spherocytes promote hypercoagulability, thrombosis
thrombosisresearch.com/article/S0049-…

Ascorbate also needed for immune response
ncbi.nlm.nih.gov/pmc/articles/P…
Further depletes.
Read 8 tweets
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ice9
@__ice9
@monarchdiaries @lewistlc @aliostad @BioBreakout @aknappjr @YinPD @InceptionCap @hcornea @icedoc61 It's real.

@monarchdiaries @lewistlc @aliostad @BioBreakout @aknappjr @YinPD @InceptionCap @hcornea @icedoc61 The literature is very extensive. And heparin among other things apparently can indeed work.

@monarchdiaries @lewistlc @aliostad @BioBreakout @aknappjr @YinPD @InceptionCap @hcornea @icedoc61 The only significant disputes I see involve *which* anticoagulants to use-- not whether or not to use them.

Nebulized heparin looks better than systemic.

pubmed.ncbi.nlm.nih.gov/31262641/

ejbronchology.eg.net/article.asp?is…

atsjournals.org/doi/10.1164/rc…

atm.amegroups.com/article/view/1…

Read 3 tweets
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ice9
@__ice9
@randicus79 @InceptionCap @YinPD @BioBreakout @AppleHelix @aknappjr Currently, I see the strongest evidence for [hydroxy]chloroquine, umifenovir (weak but non-negligible), tocilizumab (probably also sarilumab and siltuximab), nebulized interferon alpha-2b

These also show some apparent success in human use: favipiravir, ciclesonide, remdesivir
@randicus79 @InceptionCap @YinPD @BioBreakout @AppleHelix @aknappjr For combination prophylactic antibiotics and anti-inflammatories, azithromycin appears to be a reasonable choice. Could perhaps substitute doxycycline or minocycline in patients with QT prolongation issues -- they also have a history of use in this role.
@randicus79 @InceptionCap @YinPD @BioBreakout @AppleHelix @aknappjr There are some indications that ARBs like losartan may be useful in moderate and worse cases.

There is circumstantial evidence that anticoagulants may become useful in critical cases, for preventing intravascular coagulopathy in the microvasculature of the lungs.
Read 5 tweets

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Aman Thind
@Thind888
*Fine-tuning breath delivery to maximize CO2 elimination in ARDS*

1/
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Enhanced CO2 elmination would allow reduction of delivered minute ventilation (and hence, VILI).

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Excited to join this @ACCinTouch Webinar.

Why pay attention⁉️

1. COVID19: worse w/ baseline CV Dz🥵
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LisaFischer
@FactFisching
On Thursday, the @EIB board (Member States, @EU_Commission) decides whether funding #gas infrastructure is still in the public interest.

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Ankit Timbadia
@AnkitTimbadia
Can someone explain how does pricing work for all the eCommerce websites like @myntra First screenshot shows the product which I had bought when not on sale and on sale the price was inflated to almost 3X with 25% off?
Do sellers have control over the pricing or @myntra has it?
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Dr. Çağrı Mert Bakırcı
@cagrimbakirci
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George Colgrove III ⭐️⭐️⭐️
@colgrove11
To get up to speed with Q this is my recommendation:

Follow @StormIsUponUs and turn on his alerts. This gets you plugged into the here and now in easy to understand pragmatic and clear Q-centric posts.

Go to YouTube and subscribe to @IPOT1776 & @WarDrummer1 & Stroppy Me
@IPOT1776 is entertaining and informative and will give you a craving for Cake and Woppers.

@WarDrummer1 will give you the best readings of Serial Brain 2. You can get a good idea how decodes work.

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... opinions without judgement.

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These three will spawn curiosity and interest within you for you to proceed to do internet searches to answer your questions.

Asking others these questions...
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