Discover and read the best of Twitter Threads about #Voriconazole
Most recents (5)
#idboardreview heart-lung transplant 2yrs ago on tacrolimus, mycophenolate, TMP/SMX, lung nodules on voriconazole, +diffuse body aches, AlkP 2x ULN, Bone scan numerous scattered areas of uptake. Xray periosteal thickening, Calcified excrescences. dx? #medEd #idmedEd #idtwitter 
#Voriconazole SE vision changes, rash, nausea, vomiting, abnormal liver function tests, hallucinations
#Periostitis w/ long term voriconazole diffuse body aches, ,inc AlkP patches of periosteal thickening on Xray &+bone scan. Calcified excrescences are sometimes seen.
#Periostitis w/ long term voriconazole diffuse body aches, ,inc AlkP patches of periosteal thickening on Xray &+bone scan. Calcified excrescences are sometimes seen.
Finally got to analyze & put my thoughts together on the recent #posaconazole vs. #voriconazole phase 3 trial for invasive #aspergillosis published in .@TheLancet a few weeks ago.
Best is to put the major trials of the 3 #VIP triazoles done over the last 20 years in perspective!
Best is to put the major trials of the 3 #VIP triazoles done over the last 20 years in perspective!
So (re)studied the following key trials & appendices
#Posaconazole vs. #Voriconazole: thelancet.com/journals/lance…
#Isavuconazole vs. Vori: thelancet.com/journals/lance…
#AmphotericinB vs. Vori: nejm.org/doi/10.1056/NE…
#TxID #IDTwitter
#Posaconazole vs. #Voriconazole: thelancet.com/journals/lance…
#Isavuconazole vs. Vori: thelancet.com/journals/lance…
#AmphotericinB vs. Vori: nejm.org/doi/10.1056/NE…
#TxID #IDTwitter
Here is the table with key points of trial design of the #TresAmigos trials, interesting features:
#Vori-Ampho was open label, but with blinded adjudication, including to adverse effects.
All where non-inferiority trials, #vori-amphoB had a clause for claiming superiority.
#Vori-Ampho was open label, but with blinded adjudication, including to adverse effects.
All where non-inferiority trials, #vori-amphoB had a clause for claiming superiority.
#MayoIDQ: 86M DM
2 wk of R ear pain / nasal discharge
Now: R frontal HA, facial pain, vision loss
PE: R ptosis, CN III, IV, VI palsies, purulence R middle meatus
CT: R sided paranasal sinusitis w/ phlegmonous extension to orbital apex
What is DDx, work up and etiology?
2 wk of R ear pain / nasal discharge
Now: R frontal HA, facial pain, vision loss
PE: R ptosis, CN III, IV, VI palsies, purulence R middle meatus
CT: R sided paranasal sinusitis w/ phlegmonous extension to orbital apex
What is DDx, work up and etiology?
2/
Diagnosis: Orbital Apex Syndrome
S/S due to involvement of structures in orbital apex: most common vision loss and painful / limited eye movement
CN palsies
* Optic nerve
* Oculomotor nerve
* Trochlear nerve
* First division of trigeminal nerve
* Abducens nerve
Diagnosis: Orbital Apex Syndrome
S/S due to involvement of structures in orbital apex: most common vision loss and painful / limited eye movement
CN palsies
* Optic nerve
* Oculomotor nerve
* Trochlear nerve
* First division of trigeminal nerve
* Abducens nerve
3/
DDx (overlapping symptoms) of orbital apex syndrome
1. Cavernous sinus thrombosis
2. Superior orbital fissure syndrome
ncbi.nlm.nih.gov/pmc/articles/P…
DDx (overlapping symptoms) of orbital apex syndrome
1. Cavernous sinus thrombosis
2. Superior orbital fissure syndrome
ncbi.nlm.nih.gov/pmc/articles/P…
Hey #MedTwitter!!
This morning at our VA we had Chief @photon_ick give us a case of #ChronicSOB, where it turned out that the patient had #ABPA (#allergic bronchopulmonary #aspergillosis). It's a diagnosis we don't see too often, but one you'll definitely encounter here!! 🗝️👇
This morning at our VA we had Chief @photon_ick give us a case of #ChronicSOB, where it turned out that the patient had #ABPA (#allergic bronchopulmonary #aspergillosis). It's a diagnosis we don't see too often, but one you'll definitely encounter here!! 🗝️👇
This is an #allergic condition, with 2 main predisposing conditions: #asthma & #cysticfibrosis
It can be more rarely seen in other lung disease/immunodeficiencies, but without the right lung environment like this, it is almost NEVER seen!!
It can be more rarely seen in other lung disease/immunodeficiencies, but without the right lung environment like this, it is almost NEVER seen!!
#Remdesivir begins distribution in the #USA today via #EUA.
I thought would write down some practical #tips based on my #qualitative anecdotal experience after personally treating close to 200 patients with #COVID19.
For quantitative results, wait for the papers¬—thread
I thought would write down some practical #tips based on my #qualitative anecdotal experience after personally treating close to 200 patients with #COVID19.
For quantitative results, wait for the papers¬—thread
“this juice works, doc!” When you hear similar expressions 1-2 days after starting #remdesivir multiple times, you start to wonder. Don't recall a similar proportion of patients smile after feeling so sick 1-2 days earlier with #COVID19. x/n? Wait for the papers.
Like #treatment for any severe infectious disease (meningitis, Gram-negative bacteremia, influenza pneumonia, etc), earlier is always better. #COVID19 is no different. #Remdesivir stops #SARS-CoV2 replication, but won’t heal the lung injury.
