Discover and read the best of Twitter Threads about #surgery
Most recents (24)
130 yrs ago this month, Dr. Daniel Hale Williams, a Black surgeon at Provident Hospital in Chicago whose ancestors were slaves, performed what was then believed to be the first open #heart #surgery. A thread... (1)
The patient, 24yo James Cornish, had been stabbed with a knife in the chest in a saloon scuffle. He was bleeding profusely when he was dropped off at the hospital by a horse-drawn ambulance. (2)
With no diagnostic equipment other than a stethoscope - X-rays would not be discovered for another 2 yrs—Williams examined him. The stab wound was slightly to the left of the breastbone and directly over the right ventricle. (3)
1/
🎬 Now on stage Professor @giovannilandoni talking about what we DON'T KNOW about #cardiocirculatory drugs
✅ #Norepineprhine is the most used vasoactive drug in the guidelines for:
🔹 #sepsis
🔹#cardiogenic shock❗(Scandinavian)
BUT...
@Smart_Meeting_M @SRAnesthesiaICU
🎬 Now on stage Professor @giovannilandoni talking about what we DON'T KNOW about #cardiocirculatory drugs
✅ #Norepineprhine is the most used vasoactive drug in the guidelines for:
🔹 #sepsis
🔹#cardiogenic shock❗(Scandinavian)
BUT...
@Smart_Meeting_M @SRAnesthesiaICU
2/
BUT... #Norepineprhine (base) does not exist❗
🚫 base is not soluble, unstable and unable to reach target receptors
💡 Let's make it a salt!
🤔 But which one?
⚠️ Available Norepineprhine salts has different #dilution
⚠️ Sometimes with misleading #labeling
BUT... #Norepineprhine (base) does not exist❗
🚫 base is not soluble, unstable and unable to reach target receptors
💡 Let's make it a salt!
🤔 But which one?
⚠️ Available Norepineprhine salts has different #dilution
⚠️ Sometimes with misleading #labeling
3/
➡️ Please do not change you're clinical practice for this ⬅️
But consider the possible implications on:
🔹Second line drugs initiation
🔹Co- administration of other vasopressors
❗Comunication of your results!!!
pubmed.ncbi.nlm.nih.gov/36978126/
#FOAMed #FOAMcc
➡️ Please do not change you're clinical practice for this ⬅️
But consider the possible implications on:
🔹Second line drugs initiation
🔹Co- administration of other vasopressors
❗Comunication of your results!!!
pubmed.ncbi.nlm.nih.gov/36978126/
#FOAMed #FOAMcc
Been a while since I’ve done one of these.
A recent personal health related saga motivated me to put this one together. 👇
A 🧵
1/
A recent personal health related saga motivated me to put this one together. 👇
A 🧵
1/
First off, I am now fully recovered.
Thankful to the fantastic clinical teams @WRBethesda for the excellent and timely care provided. 🙏
2/
Thankful to the fantastic clinical teams @WRBethesda for the excellent and timely care provided. 🙏
2/
3 months ago, I began having post-prandial epigastric abdominal pain lasting 30-90 mins would resolve spontaneously…until one night, it just didn’t.
Pain 10/10. Could not sit still, constant with intermittently colicky. Went to the nearest ED.
3/
Pain 10/10. Could not sit still, constant with intermittently colicky. Went to the nearest ED.
3/
A 17-YO: a 3-week of dizziness, headache, & weakness of the R leg
MR: ring-enhancing lesions in the frontal lobe & basal ganglia on the L side (A; T1-W) as well as surrounding edema & midline shift (B; T2-W)
1/6
DOI: 10.1056/NEJMicm2202196
#neurology #radiology #IDTwitter
MR: ring-enhancing lesions in the frontal lobe & basal ganglia on the L side (A; T1-W) as well as surrounding edema & midline shift (B; T2-W)
1/6
DOI: 10.1056/NEJMicm2202196
#neurology #radiology #IDTwitter
IgG ab for Echinococcus multilocularis & E. granulosus: ➖
Surgical excision🔬: necrotic tissue, granulomatous inflammation, echinococcal laminated membrane (C, arrow) & an intact cyst (D, arrow)
RT-PCR: ➕for E. multilocularis
2/6
#parasitology #Pathologists #pathology
Surgical excision🔬: necrotic tissue, granulomatous inflammation, echinococcal laminated membrane (C, arrow) & an intact cyst (D, arrow)
RT-PCR: ➕for E. multilocularis
2/6
#parasitology #Pathologists #pathology
CT imaging of the chest and abdomen did not show any other sites of disease.
CEREBRAL ALVEOLAR ECHINOCOCCOSIS
3/6
DOI: 10.1056/NEJMicm2202196
#microbiology #MedTwitter #Doctor
CEREBRAL ALVEOLAR ECHINOCOCCOSIS
3/6
DOI: 10.1056/NEJMicm2202196
#microbiology #MedTwitter #Doctor
Demystifying membrane anatomy: Towards a new era of abdominopelvic surgery
#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #surgery #surgeon #anatomy
cell.com/the-innovation…
#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #surgery #surgeon #anatomy
cell.com/the-innovation…
Diagram of embryonic development and characteristics of membrane anatomy under laparoscopy
It will probably redefine the surgical scope of complete resections of pelvic tumors (cervical, rectal, and bladder cancer), improve nerve-sparing and pelvic floor reconstruction, and reduce operative bleeding and surgical injuries.
A 6-YO Bedouin ♂️: a limp, headache, left facial nerve palsy, & left hemiparesis.
Blood eosinophil count of 890/μL.
MRI: a brain cyst.
1/8
DOI: doi.org/10.4269/ajtmh.…
#neurology #pediatric #MedTwitter
Blood eosinophil count of 890/μL.
MRI: a brain cyst.
1/8
DOI: doi.org/10.4269/ajtmh.…
#neurology #pediatric #MedTwitter
Abdominal ultrasound and chest radiography did not reveal additional cysts.
Blood serology (ELISA) for ECHINOCOCCOSIS: ➖
The brain cyst was fully removed surgically.
2/8
DOI: doi.org/10.4269/ajtmh.…
#neuro #Pediatrics #surgery
Blood serology (ELISA) for ECHINOCOCCOSIS: ➖
The brain cyst was fully removed surgically.
2/8
DOI: doi.org/10.4269/ajtmh.…
#neuro #Pediatrics #surgery
Histopathological examination of the brain cyst fluid showed several echinococcal larvae (C and D), confirming CYSTIC ECHOCOCCOSIS diagnosis.
Over the following 4 months, he was treated with albendazole without complications.
3/8
#parasitology #microbiology #IDtwitter
Over the following 4 months, he was treated with albendazole without complications.
3/8
#parasitology #microbiology #IDtwitter
QuizTime 11
Good afternoon my dear friends
32 yr F
>1yr duration
H/O burn
Slowly progressing
Dx & Management?
#MedTwitter #dermatology #dermtwitter #MedEd #NEET #FOAMed #surgery #scar
Good afternoon my dear friends
32 yr F
>1yr duration
H/O burn
Slowly progressing
Dx & Management?
#MedTwitter #dermatology #dermtwitter #MedEd #NEET #FOAMed #surgery #scar
Hypertrophic Scar HTS
Keloids and (HTS) are the result of an overgrowth of fibrous tissue following healing of a cutaneous injury
Keloids and (HTS) are the result of an overgrowth of fibrous tissue following healing of a cutaneous injury
Keloids
Extend beyond the margins of the original wound
Do not usually regress spontaneously
Tend to recur after excision
HTS
do not expand beyond the boundaries of the initial injury may undergo partial spontaneous resolution.
Extend beyond the margins of the original wound
Do not usually regress spontaneously
Tend to recur after excision
HTS
do not expand beyond the boundaries of the initial injury may undergo partial spontaneous resolution.
[1/5] #Glioblastoma comprises 49.1% of all primary malignant brain tumors and approximately 12,000 cases are diagnosed each year in the US. A recent study In @JAMAOnc investigated whether the addition of an...
[2/5] autologous tumour lysate-loaded dendritic cell vaccine (DCVax-L) to the traditional standard of treatment (#surgery, #radiotherapy, and #chemotherapy) for glioblastoma prolonged survival.
#Neurology #Oncology #brain
#Neurology #Oncology #brain
[3/5] DCVax-L was found to be promising in extending survival for patients with newly diagnosed glioblastoma who are also receiving standard treatment for their disease.
#HealthcareNews #medicine #MedEd
#HealthcareNews #medicine #MedEd
As a #medicine resident you'll come across 👇🏻 scenario often.
Your #surgery colleagues want you to opine on the type and duration of ANTICOAGULATION and also want to know why it occured in the first place🤷♂️
Let's dig deeper 👇🏻
1/24
#MedTwitter #DVT
Your #surgery colleagues want you to opine on the type and duration of ANTICOAGULATION and also want to know why it occured in the first place🤷♂️
Let's dig deeper 👇🏻
1/24
#MedTwitter #DVT
Yeah, this is obviously a Deep Vein Thrombosis (DVT) !
It's fairly common, develops in about 1/1000 people 😮
Remember, DVT+PE = VTE
PE= pulm embolism
VTE= venous thromboembolism
⭐1/3 DVT develop PE⭐
The PE is what can lead to mortality!
Preventing PE is IMPORTANT 🙏🏻
2/24
It's fairly common, develops in about 1/1000 people 😮
Remember, DVT+PE = VTE
PE= pulm embolism
VTE= venous thromboembolism
⭐1/3 DVT develop PE⭐
The PE is what can lead to mortality!
Preventing PE is IMPORTANT 🙏🏻
2/24
DVT is not less of a monster !
Many w/ DVT will develop post thrombotic syndrome 😮 That's a lot of morbidity, leg pain, swelling, ulceration and all 😭
But
🔸Why does VTE occur ?
🔸Who's at risk of developing it ?
🔸Can we prevent it ?
🔸How does one treat it ?
3/24
Many w/ DVT will develop post thrombotic syndrome 😮 That's a lot of morbidity, leg pain, swelling, ulceration and all 😭
But
🔸Why does VTE occur ?
🔸Who's at risk of developing it ?
🔸Can we prevent it ?
🔸How does one treat it ?
3/24
Hey #medtwitter! Today #scientissimum would like to show you an #emergency #surgery #trauma case. The patient she was found to have suffered a gunshot wound, broken ribs, but otherwise unhurt. There was a bullet entry wound on the left side of her chest.🎈🎈 (1/5)
#MondayMorning
#MondayMorning
but the rib fracture was seen on the right. Evidence pointed out that after entering the left side, the bullet bounced off across her sternum and into the right breast, fracturing her right rib. Evidence pointed out that after entering the left side, (2/5)
the bullet bounced off across her sternum and into the right breast, fracturing her right rib.
Had the bullet penetrated the left side of the chest, it would have caused injury to the heart and left lung, costing her life. Using a high-resolution CT scan, the doctors were (3/5)
Had the bullet penetrated the left side of the chest, it would have caused injury to the heart and left lung, costing her life. Using a high-resolution CT scan, the doctors were (3/5)
A 65-YO man, from North African: asymptomatic dorsolumbar mass for 30 years with normal skin appearance.
MRI: ?
1/6
doi.org/10.1093/cid/ci…
#radiology #MedTwitter #parasitology
MRI: ?
1/6
doi.org/10.1093/cid/ci…
#radiology #MedTwitter #parasitology
MRI: a multivesicular cyst in the latissimus dorsi muscle (arrow)
🧪for Echinococcus granulosus: ELISA, & Western blot➕
Surgery: multiple daughter vesicles of E. granulosus, with the presence of multiple scolices
INTRAMUSCULAR HYDATID CYST
2/6
#parasites #medicine #radres
🧪for Echinococcus granulosus: ELISA, & Western blot➕
Surgery: multiple daughter vesicles of E. granulosus, with the presence of multiple scolices
INTRAMUSCULAR HYDATID CYST
2/6
#parasites #medicine #radres
No puncture should be performed, to avoid dissemination of the cysts that can cause an anaphylactic shock.
The patient received 3 other courses of albendazole: serologic control became negative after 1 year.
3/6
#IDtwitter #surgery
The patient received 3 other courses of albendazole: serologic control became negative after 1 year.
3/6
#IDtwitter #surgery
About 5 years ago I had 150 new people following me every day. My tweets were seen by many then one day it all stopped…. A website in Europe detected that I was #shadowbanned by @twitter 1/
Clearly my tweets and retweets were not getting the same impact - I had gained notoriety from my social media presence and I had no answers. I had no recourse. No one at #twitter would respond to my texts, emails, or calls. So… I just worked harder… 2/
A 26-yo👩🦰, #sexually active, with 1 partner: right knee and metacarpal arthralgia, tenosynovitis and pustules on her hand.
CT: an abscess on her chest wall
1/9
doi.org/10.1503/cmaj.2…
#IDtwitter #MedTwitter #emergency
CT: an abscess on her chest wall
1/9
doi.org/10.1503/cmaj.2…
#IDtwitter #MedTwitter #emergency
✔️Urine gonococcal nucleic acid amplification test (NAAT):➕
✔️🧫from the patient’s chest wall fluid:➖but
✔️16S rRNA with gene sequencing confirmed presence of Neisseria gonorrhoeae.
CHEST WALL ABSCEST WITH DISSEMINATED GONOCOCAL INFECTION
2/9
#microbiology #MolBiol
✔️🧫from the patient’s chest wall fluid:➖but
✔️16S rRNA with gene sequencing confirmed presence of Neisseria gonorrhoeae.
CHEST WALL ABSCEST WITH DISSEMINATED GONOCOCAL INFECTION
2/9
#microbiology #MolBiol
Her doctors treated her with incision and drainage and intravenous ceftriaxone 2 g/d. for 17 days after resolution of the abscess
If chlamydia infection has not been ruled out, chlamydia treatment with doxycycline for 7 days should be added.
3/9
#surgery #MedStudentTwitter
If chlamydia infection has not been ruled out, chlamydia treatment with doxycycline for 7 days should be added.
3/9
#surgery #MedStudentTwitter
The role of #surgery in inflammatory bowel disease with
@IBDBen
#MedTwitter #GITwitter #IBD #ACG2022
@IBDBen
#MedTwitter #GITwitter #IBD #ACG2022
Good medical therapy has reduced need for surgery, but many still will require surgery
Over time, more surgery is elective (yay!)
⚠️Black >>> white for diverticular bleeding and rates are 📈
Urgent colonoscopy in acute lower GI bleed?
A Medical Practitioners Tribunal found cosmetic surgeon Dr Christopher Inglefield misled a serious incident review meeting.
His actions were dishonest.
#OpenJustice #Surgery #MedTwitter lbps.co.uk/plastic-surger…
His actions were dishonest.
#OpenJustice #Surgery #MedTwitter lbps.co.uk/plastic-surger…
At a serious incident review meeting with the Phoenix Hospital Group on 16/11/18, Dr Inglefield lied about his practice, London Bridge Plastic Surgery & Aesthetic Clinic informing the Care Quality Commission (CQC) of a serious clinical incident on 7/8/18
mpts-uk.org/hearings-and-d…
mpts-uk.org/hearings-and-d…
The tribunal has found Dr Inglefield’s fitness to practise to be impaired by reason of his misconduct. We requested the finding of facts that were handed down last week and will post on our substack when received. tribunaltweets.substack.com
#OpenJustice #Surgery #MedTwitter
#OpenJustice #Surgery #MedTwitter
A 58-YO, toothache: swelling in the neck, sore throat, chills, chest pain; oral cavity indurated & woody, neck adenopathy; erythema spreading from his neck down over his anterior chest wall (A & B)
¼
#MedEd #IDtwitter #dermatology #MedTwitter
DOI: 10.1056/NEJMicm065036
¼
#MedEd #IDtwitter #dermatology #MedTwitter
DOI: 10.1056/NEJMicm065036
LUDWING´S ANGINA is an infectious process involving the submental, sublingual, and submandibular spaces.
It can rapidly progress to hemodynamic instability and airway obstruction; in rare cases, it spreads into the mediastinum.
2/4
#Doctor #MedStudentTwitter #resident
It can rapidly progress to hemodynamic instability and airway obstruction; in rare cases, it spreads into the mediastinum.
2/4
#Doctor #MedStudentTwitter #resident
Compromise of the airway can progress rapidly, with lethal consequences; therefore, immediate consideration should be given to surgical débridement of the infected areas and antimicrobial therapy.
¾
#medicine #MedicalStudents #microbiology #surgery
¾
#medicine #MedicalStudents #microbiology #surgery
1/n) ICMR released Standard Treatment Workflows (STWs) volume 3 which contains 11 specialties with 52 diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App.
@MoHFW_INDIA @DeptHealthRes #STW
@MoHFW_INDIA @DeptHealthRes #STW
2/n) Standard Treatment Workflows (STWs) on #𝐃𝐞𝐫𝐦𝐚𝐭𝐨𝐥𝐨𝐠𝐲 containing 14 major diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App. @MoHFW_INDIA @DeptHealthRes
3/n) Standard Treatment Workflows (STWs) on #Endocrinology containing 06 major diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App. @MoHFW_INDIA @AyushmanNHA @WHOSEARO #diabetes
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.
For any 3rd year #medstudents starting on #surgery, here are some tips I found helpful as to how to be successful on this rotation:
1. Arrive early - on time is 15 min before start. Offer to print the patient list and write new lab values before sign out from the night 🧵
1. Arrive early - on time is 15 min before start. Offer to print the patient list and write new lab values before sign out from the night 🧵
2. Stalk the OR board the night before. Know who’s going and for what reason. If there’s any surgeries you’re unfamiliar with, look up the anatomy the night before.
3. Get to the OR before your patient. Get to know the scrub techs and nurses, give them your gloves and gown if you’re scrubbing in, joke with them and make friends - your experience will be SO much better!
A 51-YO🧔♂️, in Turkey: dyspnea, cough & production of yellowish, foul-smelling, & salty sputum
XR & CT (A-D): cavitary lesion containing irregular, serpiginous intracavitary material
1/3
DOI: doi.org/10.4269/ajtmh.…
#IDTwitter #radiology
XR & CT (A-D): cavitary lesion containing irregular, serpiginous intracavitary material
1/3
DOI: doi.org/10.4269/ajtmh.…
#IDTwitter #radiology
2nd day of hospitalization: fever, myalgia, & sore throat
CT: subpleural ground glass opacities (fig.)
PCR for #SARSCoV2:➕
Eosinophilia
IFA IgG against Echinococcus granulosus:➕at 1/5,120
RUPTURED PULMONARY HYDATIC CYST COMPLICATED BY COVID-19
2/3
#microbiology #MedEd
CT: subpleural ground glass opacities (fig.)
PCR for #SARSCoV2:➕
Eosinophilia
IFA IgG against Echinococcus granulosus:➕at 1/5,120
RUPTURED PULMONARY HYDATIC CYST COMPLICATED BY COVID-19
2/3
#microbiology #MedEd
Gross examination showed removed cyst (fig.).
Surgery combined with medical therapy remains the standard form of treatment of large cysts with multiple daughter cysts, complicated cysts, etc.
3/3
#parasitology #surgery
Surgery combined with medical therapy remains the standard form of treatment of large cysts with multiple daughter cysts, complicated cysts, etc.
3/3
#parasitology #surgery
The Locksmith Paradox and Medicine
A Thread 🧵
#medicine #urology #surgery
@usioffice @YouthUSI @so_uro @docdilipmishra @rbsabnis @raggy_k @pprao @AnilElhence @Rahul79307822 @drkamaljeet @sanjaybkulkarni @DrSanjayPande10 @BAUSurology @AmerUrological @LoebStacy
A Thread 🧵
#medicine #urology #surgery
@usioffice @YouthUSI @so_uro @docdilipmishra @rbsabnis @raggy_k @pprao @AnilElhence @Rahul79307822 @drkamaljeet @sanjaybkulkarni @DrSanjayPande10 @BAUSurology @AmerUrological @LoebStacy
There’s a locksmith who as he gets better, moves from assistant to master, ends up upsetting customers because he can fix their locks quickly.
The locksmith is saving - time and money for client. But they don't feel the value is there for money due to the shortened time input.
The locksmith is saving - time and money for client. But they don't feel the value is there for money due to the shortened time input.
Fable says Pablo Picasso faced a similar paradox. One warm summer’s day he was sitting in a park when a woman recognised the artist, approached him, and insisted he sketch her. Smiling Picasso reached for his sketchpad and created her portrait with a single stroke of his pencil.
Tomorrow I will attend my last @ACOS_MSS Convention. Feels like yesterday resurrecting #surgery at TCOM. Now so many future DO surgeons follow this path. From nothing to national conventions (virtual & in-person) in 4 years.
You don’t stop being a leader when you feel failure.
You don’t stop being a leader when you feel failure.
I’ve mentored so many in surgery, and it will no doubt be tough to walk in those doors to a national convention of people who look up to me. This is definitely not how I imagined this last one going down. However…you don’t stop being a leader when you feel failure.
Throughout history, many of the “greatest of their time” leaders/commanders/professionals failed in the face of their respective colleagues. In fact, the way they handled that failure before their audience was the toughest form of leadership to follow through with. It’s not easy.
A (LONG) thread for patients with #mecfs #longcovid expecting surgery and the #surgeons #anesthesiologists #crnas and #pacunurses caring for them. I'll share my recent perioperative experience. This is neither comprehensive nor medical advice, but I hope it helps. (0)
1. Recovery was a bitch. I've had general anesthetics before, even in the same organ system. This was not the same body undergoing #anesthesia.
2. Set Expectations: Physicians
Expect long lists of meds, allergies, requests, and questions. Listen to and engage with your patient. They may educate you. Anticipate a potentially prolonged and complicated recovery. This is not a fast-track. Respectfully, don't be a Dick.
Expect long lists of meds, allergies, requests, and questions. Listen to and engage with your patient. They may educate you. Anticipate a potentially prolonged and complicated recovery. This is not a fast-track. Respectfully, don't be a Dick.
