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More from @CMichaelGibson

C. Michael Gibson MD

@CMichaelGibson

Feb 26

People with "Chronic fatigue sydrome" #CFS or #myeloencephalitis (ME) have distinct immune abnormalities
(a thread) scientificamerican.com/article/people…

In their blood, the killer T cells, which normally target infected cells for destruction, had reduced levels of a protein called CD226 that would otherwise boost their proliferation and activity.

In the cerebrospinal fluid, killer T cells had elevated levels of programmed cell death protein 1 (PD1). This protein is considered an “exhaustion” marker, and its presence can indicate that an overstimulated T cell has shut down. Their immune system is burned out.

Read 4 tweets

C. Michael Gibson MD

@CMichaelGibson

Mar 25, 2021

How can there be disagreement between groups about the effectiveness of a drug in an interim analysis? I have NO specific information about the AZ analysis, but let me make some GENERAL comments (thread)

The timing of an interim analysis is often pre-specified (planned in advance) so that the date cannot be “cherry picked” to “make the results look good”. In this case it was pre-specified that events that occurred through February 17th would count.

Can you imagine the criticism researchers would face if they changed the date? Could you imagine the criticism if the results were reversed such that through Feb 17 there was 76% effectiveness & AZ decided to report 79% based on “more recent”preliminary data?

Read 23 tweets

C. Michael Gibson MD

@CMichaelGibson

Mar 23, 2021

Viewpoint:

In the era of widely available lipid-lowering therapies, plaque erosion instead of plaque rupture may account for an increasing proportion of ACS.

Stenting may not be needed for management of erosion-induced ACS. ja.ma/3cbQPZC

Here is the data supporting medical management as opposed to stenting in the patient with plaque erosion ja.ma/3lLnjNI

Among patients in whom there is plaque erosion and no plaque rupture, do you use medical therapy instead of implanting a stent? If not, why are you putting a stent in?

Read 4 tweets

C. Michael Gibson MD

@CMichaelGibson

Jan 16, 2021

Stop tweeting

Start vaccinating

Heading out to vaccinate “people” in Rhode Island today

It may not be a big stadium, it may only be a VFW, it may only be 450 little shots, but these “people” are somebody’s world ... let’s give their community a big shot in the arm
#cmgsays

The COVID vaccination is an intramuscular injection. It is NOT a subcutaneous injection. To give a #COVID19 IM injection DO NOT pinch the skin & Do NOT angle the needle at 45 degrees. This will cause the injection to go into the subcutaneous fat rather than the deltoid muscle.

To give an IM injection, aim the needle perpendicular to or at 90 degrees to the skin. The CDC does not recommend that you draw back on the needle (there are no big vessels in the deltoid muscle),

Read 11 tweets

C. Michael Gibson MD

@CMichaelGibson

Nov 13, 2020

Many have become numb to pandemic statistics

Healthcare workers, though, must face the reality that there are now MORE PATIENTS HOSPITALIZED THAN AT ANY TIME in 2020, 40% more than 2 weeks ago

Some are working 36 hrs straight

The 3rd wave may break us

theatlantic.com/health/archive…

"They require twice as much attention as a typical intensive-care unit patient, for three times the normal length of stay. “It was doable over the summer, but now it’s just too much,”

“Last Monday we had 25 patients waiting in the emergency department. They had been admitted but there was no one to take care of them.” I asked her how much slack the system has left. “There is none,” she said.

Read 11 tweets