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Nov 29, 2022 20 tweets 8 min read Read on X
1/19 Welcome to this #CME #Tweetorial on #Influenza and #PediatricFlu with @RishiDesaiMD, supported by an educational grant from Genentech.

See full CME info: bit.ly/3Eczmx6
#MedTwitter #MedEd Image
2/Let’s begin!
Influenza (flu) can cause severe illness and death. In the US, during the 2019-2020 (pre-pandemic) flu season, 20,000 deaths occurred due to flu-related complications. Image
3/During the pandemic, social distancing, masking, and quarantining significantly reduced flu-related illnesses/deaths. In the US, during the 2021-2022 (pandemic) flu season, 5,000-14,000 deaths occurred due to flu-related complications (down from 20,000!). ImageImage
4/Vaccines are one way to reduce flu transmission and disease burden. In a “well-matched” season, vaccines reduce the risk of illness by 40%-60%, but in a “mismatched” season (when the dominant flu strain is different from the one in the vaccine), vaccines are less effective.
5/Time for a poll! What percentage of children aged 6 months to 4 years received the flu vaccine in 2020-2021?
6/If you answered B (68%), you are correct! The percentage of children who got the flu vaccine was highest among those aged 6 months to 4 years (68%), followed by children 5-12 years (59%), and lowest among children 13-17 years (51%). Image
7/In the ongoing pandemic, it’s important to keep in mind that flu symptoms overlap with COVID-19 symptoms, and the two viruses can co-occur. Image
8/Testing can help determine whether symptoms are caused by flu or COVID-19. Flu tests have limitations, for example:
• Rapid antigen tests have a high false-negative rate
• Viral cultures take 3-10 days for results
• RT-PCR can be expensive Image
9/The #CDC recommends starting antiviral treatment as soon as possible (≤ 48 hours) for patients with confirmed/suspected influenza who have or are at risk of severe disease, such as young children.
10/M2 proton channel blockers (amantadine and rimantadine) have been used historically as antiviral treatment but have high rates of resistance and aren’t recommended in the US.
11/Oseltamivir (PO BID x 5 days) can be used in children aged ≥ 2 weeks. Image
12/Zanamivir (INH BID x 5 days) can be used in children aged ≥ 7 years but is not recommended in people with underlying respiratory disease. Image
13/Peramivir (1 IV infusion) can be used in children aged ≥ 6 months. Image
14/Baloxavir Marboxil (aka baloxavir) (1 PO dose) can be used in children aged 5-12 years with no chronic medical condition and in any child aged ≥ 12 years. ImageImage
15/Snapshot of how antivirals work within the body: Image
16/For outpatients with suspected or confirmed uncomplicated influenza, oral oseltamivir, INH zanamivir, IV peramivir, or oral baloxavir may all be considered for treatment. Baloxavir has been shown to be more effective than oseltamivir against influenza B. Image
17/Time for another poll! Which of the following would be appropriate for treating uncomplicated influenza in an otherwise healthy 6-year-old boy?
I.Baloxavir (1 PO dose)
II.Oseltamivir (PO BID x 5 days)
III.Zanamivir (INH BID x 5 days)
IV.Peramivir (1 IV infusion)
18/The correct answer is D: uncomplicated influenza in an otherwise healthy 6-year-old boy can be treated with baloxavir (1 PO dose), oseltamivir (PO BID x 5 days), or peramivir (1 IV infusion). Zanamivir is not indicated in children younger than 7 years.
19/Thank you for joining this #CME #Tweetorial!
To earn CME credit or view references & glossary: bit.ly/3Eczmx6
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Dec 19, 2023
1/20 In this #CME #MedX,
@PatelOncology explores new efficacy & safety data on targeted therapies for #NSCLC from #ESMO2023
Participate for CME:
Supported by an educational grant from Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC. bit.ly/47VySZP
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2/Of the recommended biomarkers/therapeutic targets for NSCLC, exciting data on agents targeting EGFR, ALK, and PD-L1 were presented at ESMO 2023 and will be the focus of this activity. Image
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1/16 See below for this #Tweetorial on guideline and management updates for COVID-19. It is contributed by @RishiDesaiMD.
#MedTwitter #MedEd Image
2/ In all outpatient settings in which patients with COVID-19 are seen, including long-term care facilities, testing and treatment must be done in a timely manner. It is also crucial to consider patient risk factors for progression to severe disease and death. ImageImage
3/Conditions such as metabolic syndrome and obesity confer an increased risk of ICU admission, mechanical ventilation, acute respiratory distress, and death. Image
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Mar 28, 2023
1/17 See below for this #Tweetorial on #COVID-19 and risk factors for severe illness supported by an educational grant from Pfizer Inc. and contributed by @RishiDesaiMD.

#MedTwitter #MedEd Image
2/Let’s begin! The 2 preferred therapies for nonhospitalized adults with COVID-19 who have a risk of disease progression are ritonavir-boosted nirmatrelvir and remdesivir.
3/In clinical trials, remdesivir and nirmatrelvir/ritonavir reduced the risk of hospitalization and death by 87% and 88%, respectively.
Read 17 tweets
Jan 31, 2023
1/13 See below for this #Tweetorial on #COVID-19 supported by an educational grant from Pfizer and contributed by @RishiDesaiMD.

#MedTwitter #MedEd
2/Let’s begin!

COVID-19 can cause mild-to-severe symptoms (eg, runny nose, congestion, fatigue, fever, cough, nausea, and diarrhea) 2 to 14 days after exposure to the virus. Anyone with symptoms should be tested for COVID-19.
3/Anyone who does not have symptoms but has had a recent exposure to COVID-19 should be tested, as well. Here, it’s best to wait at least 5 full days after the exposure, because testing too early can lead to an inaccurate result.
Read 13 tweets
Dec 20, 2022
1/26 See below for this #Flu #CME #Tweetorial supported by an educational grant from Genentech and contributed to by @RogerSeheult.

See full CME info: bit.ly/3USfDJp
#MedTwitter #MedEd Image
2/Let’s begin!

1918 Pandemic: Naomi Barnett of Brockton, MA, learned her fiancé Jacob Julian (a soldier at Camp Upton, NY, about to go to war) had influenza, so she raced to help him. She died 2 days after arriving at the camp from influenza. He died 30 minutes later.
3/Influenza is an acute respiratory illness with significant morbidity and mortality, especially via transmission from loved ones. The CDC estimated that in the 2019-2020 (pre-COVID) US flu season, 62,000 flu-related deaths occurred. Image
Read 26 tweets
Dec 1, 2022
1/11 Welcome to this #CME #CNE #Tweetorial: Medicine During a Public Health Crisis: Just Culture in an Unjust World.

See CME/CNE info.: tinyurl.com/yv528p6j
#JustCulture #Healthcare #RaDondaVaught #MedTwitter Image
2/Per the Institute of Medicine (IOM), most medical errors arise from “faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them, rather than from reckless actions by individuals working within those systems.”
3/The just culture model serves as a guide for healthcare systems by incorporating features such as human factor design, error prevention, and steps to contain errors’ ramifications before they become critical.
Read 11 tweets

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