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Parlons un peu de la #contention #physique #passive chez les personnes âgées

- Le sujet est délicat
- Est-ce intéressant ?
- Comment trouver des alternatives ?

Un thread
#MedTwitter #gériatrie #psychogériatrie
1/36 maeker.fr
La #contention physique passive

Moyens, méthodes, matériels ou vêtements
Qui limitent les capacités de mouvements volontaires
De tout ou partie du corps
Censés garantir la sécurité
En réponse à 1 comportement dangereux/inadapté

#gériatrie

2/36
Moyens utilisés

Parmi les dispositifs se trouvent
- les barrières de lit,
- les ceintures de maintien,
- les gants de contention,
- ou encore les fauteuils inclinables avec harnais.

3/36
Read 36 tweets
Transgender health: Comparing model bills to real proposals; Many bills have preambles asserting that the risks of #gender-affirming care outweigh its benefits, which has been rebutted by major #medical organizations. courthousenews.com/transgender-he…
1) The AP obtained the texts of more than 130 bills in 40 state legislatures from Plural, a public policy software company, and analyzed them for similarities to model bills touted by the conservative groups Do No Harm and the Family Research Council.
2) The model bills have similar preambles, including the assertion — rebutted by major #medical organizations — that the risks of gender-affirming care outweigh its benefits. apnews.com/article/scienc…
Read 10 tweets
INTRAVENOUS THROMBOLYSIS (fibrinolytic therapy) can be successfull if given

A. Within 30minutes to 12 hrs in STEMI

B. Within 3-4.5 hrs in Acute ischemic stroke

C. Within 14 days in Pulmonary embolism

Choose the ✅️correct statement/s among the above.

#Medtwitter #MedEd Image
✅️TRUE statement/s among the above three
Fibrinolytic agents are plasminogen activators(PA) that act by converting plasminogen to plasmin. Plasmin then degrades the fibrin matrix of thrombi and produces soluble fibrin degradation products resulting in clot lysis. Image
Read 15 tweets
#UncommonSense
UK/US NRIs & Top 2% Indian Residents (30 Mn Income Earners > Rs6lac/per yr) praise #Medical #Facilities in India especially ability to Approach Specialists Directly

Driving though PUNE/MUM/BLR & reaching Hospital in time in a Medical Emergency is Impossible
These people generally forget that when they compare themselves to the US/UK NRIs vs the Indians in India… one is comparing the Avg US/UK citizen with the Top 2% in India

Let me explain
(1) For Indian hospitals in Major Metros in India average revenue per occupied bed (ARPOB) is Rs65k > 50% Annual Revenue for 60% of Indian population
Read 6 tweets
THREAD Re. today's expected flood of "Dear #Tito" tweets:
#OTD 25 May, is birth anniversary of former #Yugoslavia leader Josip Broz Tito. Many call it his #birthday although he has been dead for 43 yrs. I do not wish to rain on their parade, merely offer my own and my family's /2 ImageImage
THREAD to clarify, question in a PM: we were a normal & pretty ordinary non-Communist family. Not (openly) anti-Communist but not collaborating with the regime in any political capacitiy. Both my grandfathers were opposed to the idea of #Yugoslavia - they realized it may have /2 ImageImageImageImage
2/ been as a noble idea but was compromised by Greater #Serbian intentions to rule without allowing for any self-expression or federalism. My paternal grandfather (pic 4), whom I barely remember, he died when I was 6, used to say “both Yugoslavias [Kingdom proclaimed in 1918 & /3
Read 6 tweets
#Apologies can be steps towards assisting in #healing #medical #trauma. When my daughter was in @SanfordHealth for 2 months, virtually #secluded bc of accusations by #hospital administration that she causes her diabetic crisis a #hospitalist & #diabetic counselor accused 1
her of ‘stashing’ #Insulin in room. All visitors searched. No items in room unless searched - camera in room 24/7 YET she is accused of injecting #Insulin. My daughter again attempted to educate on post #TPAIT. After additional days, the #Diabetic #Counselor came back & 2
#apologized acknowledging how hard it was to control her #diabetes. It’s hard control when she is at #Baseline but if she is sick nightmare. That #apology meant the world 🌎 to my daughter. She continued to work w this #counselor throughout stay & after. YET #PatientRelations 3 Image
Read 4 tweets
Drug of choice for ANAPHYLAXIS in a patient with no response to Epinephrine?
Patient is on Propranolol 60 mg BD for essential tremors.
#MedTwitter #emergencymedicine #CriticalCare Image
Anaphylaxis is a severe, life threatening systemic hypersensitivity reaction characterized by being rapid in onset with potentially life threatening airway, breathing, or circulatory problems and is usually, although not always, associated with skin and mucosal changes.( ICD-11)
Read 9 tweets
#Pain is nuanced
The difficulty with articles such as below example, is nuances not recognized.
For example, I could identify as someone with #chronicPain I have a few conditions that are accompanied by #pain.
My #pain is NOT unrelenting, it’s there ‘hovering’ in the 1 Image
background. I do #yoga 🧘‍♂️ & #meditation & for ME, for the #pain I experience, it provides benefit.
However, take my kids; NASH, kidney disease, gastroperisis, T3, scar tissue neuropathy etc. #mindfullness #meditation is not going even touch it. Not in anyway
2 example of 2
#pain experiences.
It’s understandable that many in nation that are not in #medical profession struggle w the #nuances
What I struggle w & what I believe #harms those w #ChronicPain is the generalization of #pain by #medicalprofessionals & lack of individualizing care based 3
Read 4 tweets
27 yrs old patient, detected to be pregnant when she missed her periods one day back. She has Graves disease on Rx for past 3 years, presently on Carbimazole 5mg daily and not on propranolol. She was euthyroid with Rx for past 1 year. Best strategy ?
Present reports 👇 Image credit: Usatine RP, S...
A. Stop carbimazole and monitor by weekly/fortnightly TSH, FT4 levels and follow up.

B. Switch to PTU 50mg bd and do FT4, TSH after 2 weeks and review

C. Switch to PTU 50 mg bd + LT4 50mcg OD. TSH, FT4- 4wkly

D. PTU 50mg BD and Propranolol XL 20mg , Monthly TSH,FT4-followup
Read 21 tweets
I am sympathetic to #medical professionals as well as to #MentalHealth providers, however, IF you have uttered ☝🏼 of following statements or engaged in ☝🏼 of following behaviors you may want to reassess your #profession:

- ‘I am sorry you are to complex, complicated, we 1
can’t help you’
-‘You don’t want help bc you did not do x, y, or z’
-If you are unable to truly #Listen
-If you are unwilling to continually assess if you are negatively impacting situation
-If you use manipulation
-If you feel person & or family should not have #voice in 2
planning - it should be central.
-If you are unable to discuss difficult topics/concern w person & or family.
-If you make assumptions
-If you are unwilling to collaborate with others that support/provide care to person/family
-If you say ☝🏼 thing to person & or family & 3
Read 5 tweets
1) By legislating a ban on Gain of Function Research (GOFR) in Florida, what are you advocating and promoting with regard to #biomedical research really DeSantis? #science
2) Are you legislating that only medical research in the state of Florida will be farther removed alternatives such as single-protein or replication-incompetent virus in vitro studies, in silico modeling,…
3) or further removed long-term genetic sequence comparison of samples collected from patients are under increasingly intense investigation to replace GOFR? #biomedical #research
Read 6 tweets
#SARSCoV2 is still an international BSL3Z
AIRBORNE BIOHAZARD
1/
2020 letter for dental medical boards of directors was ignored until now

#COVIDisAirborne german Version
2/ Image
engish AI translation version
2020 letter
to ask for
#awareness & #Accountability

3/ Image
Read 6 tweets
@iltalehti_fi @heljasalonen '#Terveystoimittaja': Toisen rokotteen voimaa.
#Hus:in diagnostiikkajohtaja #LasseLehtonen rohkeni lähteä #Venäjä-Pietariin katsomaan jalkapallon EM-ottelua.
Lehtosella oli jo se toinen ja hän katsoi, että hänellä oli lupa lähteä.
iltalehti.fi/terveysuutiset… Image
@iltalehti_fi @heljasalonen #Mediapooli. Tuottamukselliset terveyden ja hengen vaarantamiset, #rokotekuolemat.
#Korruptio -rahaa vastaan, 2 vuotta valehdelleen "#toimittaja'n" asema #Nuremberg'n lavalla, kun #SpandauBallet -biisi alkaa.
- #Tuonela noutaa... ikuiseen tanssiin...
iconicphotos.wordpress.com/2009/07/30/exe… ImageImage
Read 16 tweets
🧵1/12: Writing your first case report can be a rewarding experience as it allows you to contribute to medical literature and showcase your clinical expertise. Here's a step-by-step guide to get you started! #CaseReport #MedEd #MedTwitter
🧵2/12: Start by selecting an interesting or unique case that adds value to the presentation, diagnosis, or treatment of a condition. The case should provide new insights or challenge existing knowledge. #MedicalWriting #CaseSelection
🧵3/12: Look at existing literature for similar cases. If there are less than 20 cases reported on PubMed, it's a good indication that your case might be worth sharing. A thorough literature review is essential for a successful case report. #PubMed #LiteratureReview
Read 13 tweets
👉Join us at 11am today for this important conversation as #California prepares to review eligibility for millions of #MediCal recipients. We'll be speaking with experts and health care practitioners about what this could mean. Follow the livestream: ethnicmediaservices.org/media-briefing…
Welcome to today's briefing sponsored by @DHCS_CA and organized by EMS and @CaliforniaBlac2. We'll be looking at who is at risk for being disenrolled from #MediCal under California's "great unwinding," and what people can do to get ready.
Our first speaker is Yingjia Huang, Assistant Deputy Director, Department of Health Care Services. April began the renewal process for 15 million MediCal recipients, says Huang. The process had been suspended during the #Covid pandemic.
Read 37 tweets
1) Welcome to Part 2 of a new #accredited #tweetorial in our series of educational programs on #hypertrophic #cardiomyopathy #HCM. DOn't miss Part 1, still available for 🆓CE/#CME, at cardiometabolic-ce.com/hcm5a/.
Now you can learn more, and EARN MORE credit, by following this 🧵!
2) Our expert author is again Sergio Kaiser MD PhD FACC FESC 🇧🇷🇮🇱 @pabeda1, cardiologist 🫀, Professor 🎓 of #InternalMedicine, Rio de Janeiro State University. He brings the general cardiologist's perspective to our #HCM discussions. Read and learn!
#FOAMed #CardioTwitter Image
3) This program is supported by an unrestricted educational grant from Bristol Myers Squibb. Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/. Credit for #physicians #nursepractitioners #physicianassociates #nurses #pharmacists from @academiccme.
Read 62 tweets
Are you on #pain medications or use #opioids? If so, and you do a ketogenic diet, you may find you are more sensitive to opioids. (1/6)
Now, this was a mouse study. And you are not a mouse. I am aware of that. But I am not surprised by the findings of this study. Why? (3/6)
Read 6 tweets
Warning ⚠️ ⛔️ : Uncomfortable Thread 🪡
My tweets lately have focused on my daughter’s #healthcare at @SanfordHealth & our struggle to access appropriate & compassion care where her agency is not taken away. I know the threads my be uncomfortable for some particularly if you 1
are a #medical professional. I am aware that many are thinking 💭‘what’s the back story’, ‘something they did caused this no #medical facility or #medical #professional would partake in this’. I get that. There IS a back story. A child at 2 wks having her 1st #hereditary 2
#pancreatitis flare. In 1st grade undergoing her 1st #transplant. In 6th grade undergoing 2nd #transplant. Complications, no real follow up. Complications being ignored. Physicians both on #transplant team as well as others questioning her symptoms, her #pain. Dismissing & 3
Read 18 tweets
What do aluminium sulfate water poisoning, Gulf War Syndrome, World Trade Centre Syndrome, the neurological disease #ME, the post infection disease(s) #LongCovid and poisoning of Iranian school girls have in common?

A British #psychiatrist claiming ‘mass sociogenic illness’!

1/
2/ Does the psychiatrist, Sir Simon Wessely, project his own catastrophic thinking to all ‘grey’ areas in health science transforming them into black and white?

What cannot be explained immediately can be explained through the old ‘hysteria’ hypothesis?

longcovidadvocacy.substack.com/p/professor-ca…
3/ Thank you @LongCovidAdvoc for this summary on the knighted psychiatrist’s ‘work’!

Despite Wessely repeatedly #blaming media for fueling the affected persons’ ‘mass psychogenic illnesses’ #media has seemingly been satisfied reporting this instead of performing #journalism
Read 7 tweets
Very intelligent 🧠 and #brilliant doctors. Doctor vs #DoctorWho Quiz.
Which #cytokine stimulate the growth and differentiation of #eosinophils.
#medtwitter #meded #doctor #USMLE #medical
Very intelligent 🧠 and #brilliant doctors. #Doctor vs #Doctor Quiz.
Which #cytokine stimulate the growth and differentiation of #eosinophils.
#medtwitter #meded #doctor #USMLE #medical
On Targeting #Eosinophils which clinical condition will benefit most ?
#medtwitter
Read 5 tweets
Mitochondria are essential to our overall health and well-being. In addition to producing energy, they regulate many critical processes in the body. (1/11) #mitochondria #energy #health
Mitochondria play a key role in the production and regulation of neurotransmitters. They also help produce key hormones like cortisol, estrogen, and testosterone. (2/11) #mitochondria #hormones #neurotransmitters #neurotwitter
Mitochondria are involved in epigenetics, which is the expression of #genes from the nucleus. They send signals to the nucleus that turn genes on or off. (3/11) #epigenetics #genes #mitochondria
Read 11 tweets
This thread is

Chapter 47, titled

“Forgetting:

“Our Edenal Experience in the Womb & the Loss of a “Golden Age”

“…an Account, in Fictional Form, of Being a Fetus”

of *Dance of the Seven Veils II*

by Michael Adzema

THREAD sillymickel.blogspot.com/2023/02/forget… #psyche #prenatal

D7V2 47/1
*Dance of the Seven Veils II* by Michael Adzema is due out March, 2023.

it is subtitled,

*Prenatal/Perinatal Psychology, Mythology, and Your Divine Self*

*Infant to Prenate, Veils Four-Six*

& is Volume 3 in The Path of Ecstasy Series

THREAD wp.me/pwMlb-3jX

D7V2 47/2
“[*Quotes/highlights:*] “The bond between them is a love having no source in either. It is there, ever present, flowing back & forth like waves lapping on a beach...effortlessly, lazily.” []

READ/DWL CH… 1drv.ms/b/s!AvgkzaPrRv… #psychology #prenatal #consciousness

D7V2 47/3
Read 221 tweets
A 29-year-old male presented with a 6-month history of progressive painless skin lesions over his face, back, trunk, and limbs. He had no systemic symptoms such as night sweats or weight loss.
Skin biopsy showed diffuse dermal infiltrate with blast-like cells extending to the hypodermis. Immunohistochemical analysis showed cells that were positive for CD4, CD56, and CD123.
Read 4 tweets
Did your doctor refer to the #ketogenic diet as a fad? Well, I'm sorry. But you're going to have to take a moment to educate them. 🤷‍♀️It's time for a thread. 🧵(1/7)
A common concern is that the ketogenic diet is just a fad weight loss diet & won't help with mental illness. This is far from the truth. (2/7)
The ketogenic diet has been used as a medical intervention for over 100 years to treat seizures in children with epilepsy. It's also used for adults with epilepsy. (3/7)
Read 7 tweets

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