Discover and read the best of Twitter Threads about #medhistory
Most recents (5)
Bound by blood: William Halsted, master surgeon known for pioneering radical mastectomies and starting the first surgical residency at Hopkins, had some incredible and crazy family stories - e.g. emergently transfusing his sister with his own blood!
#MedHistory #histmed #surgery
#MedHistory #histmed #surgery
He performed one of the first cholecystectomies in the US on none other than his mother, and in their kitchen at around 2 am! In 1882 he removed her gallbladder which contained 7 gallstones, and she survived and recovered completely.
He also saved his sister's life after she lost a significant amount of blood during childbirth. Seeing her going into shock, he withdrew his own blood, transfused it into her, then went on to operate and stop her bleeding. They must have had the same blood type as she recovered.
1/
Were ancient Romans chronically lead poisoned and did this contribute to the decline of ancient Rome?
This #medhistory #tweetorial explores these questions as well as the pathophysiology of Saturnine gout!
CC: @tony_breu @AdamRodmanMD @virenkaul @ETSshow @DrStevenTChen
Were ancient Romans chronically lead poisoned and did this contribute to the decline of ancient Rome?
This #medhistory #tweetorial explores these questions as well as the pathophysiology of Saturnine gout!
CC: @tony_breu @AdamRodmanMD @virenkaul @ETSshow @DrStevenTChen
2/
The hypothesis that ancient Romans may have been chronically lead poisoned was first explored in @NEJM in 1983 due to the observation that Roman aristocrats and rulers had notably high rates of gout.
bit.ly/2mnp1du
The hypothesis that ancient Romans may have been chronically lead poisoned was first explored in @NEJM in 1983 due to the observation that Roman aristocrats and rulers had notably high rates of gout.
bit.ly/2mnp1du
3/
Chronic lead exposure predisposes to gout by poisoning the proximal renal tubule's ability to excrete uric acid, ? via interference with the function of the URAT1 transporter, raising serum uric acid levels.
urlzs.com/AuMQN
Image source: goutpal.com
Chronic lead exposure predisposes to gout by poisoning the proximal renal tubule's ability to excrete uric acid, ? via interference with the function of the URAT1 transporter, raising serum uric acid levels.
urlzs.com/AuMQN
Image source: goutpal.com
On the night of January 6, 1968, @StanfordMed surgeon Norman Shumway transplanted the heart of 43-year-old Virginia White into the chest of 54-year-old Mike Kasperak. It was the first adult heart transplant to be performed in the United States. #medhistory #DonateLife
By 1967, Shumway had already spent over a decade researching heart transplantation. In 1959, he and Richard Lower had performed the world's first successful heart transplant in a dog. Thus it was widely expected that he would be the first to perform a human heart transplant.
On Nov. 20, 1967, Shumway's team announced they were ready to attempt heart transplant in a human. However, just weeks later, on Dec. 3, Christiaan Barnard took the world, and Shumway, by surprise when he reported the world's first human heart transplant.
36/M fr Arkansas w fever, epistaxis, headache, myalgia x 5 d in the summer. O/E: icteric sclerae, b/l calf tenderness. WBC 12, Hgb 10, Plt 110. Crea 6, bili 25 (direct), ALT 180, AST 130. HIV (-). He’s MSM, sewer inspector, no recent travel. What is the most likely dx?
(1/6) The majority got the right answer, leptospirosis. 🌟Elevated bilirubin out of proportion to AST & ALT (usually <200 IU) + renal failure ➡️ hallmark of Weil’s disease (severe form of leptospirosis). Other clues: nonpurulent conjunctivitis (suffusion), calf tenderness.🌟
(2/6) Note that Weil’s is a rare manifestation of leptospirosis. The most common SSx are 📌nonspecific (self-limited febrile illness). Other complications: bleeding diathesis, aseptic meningitis, pulmonary hemorrhage. #meded
51M & daughter in California admitted w fever/resp failure/hemoptysis. CXR +mutifocal PNA. Father +tender groin LN. Bcx +GNB bipolar staining. Next day, 13 other pts from the same area, admitted w severe PNA. Reported handling dead rats. Recomm isolation precaution on admission?
(1/5) Answer: droplet isolation. The rapidly progressive pneumonia, tender lymphadenopathy (index patient), epidemiologic link to handling dead rodents, the high attack rate, & the bipolar staining GNB seen on blood culture all point to 🌟📌💡plague (Yersinia pestis). #meded
(2/5) When plague is suspected, patients should be placed on 🌟droplet isolation until 48H of effective Rx (1st line: gentamicin). 📌Person-person transmission of plague has only been observed in the pneumonic form. 💡#meded
