Spoke with my neighbour. A type 2 diabetic on medications and realized even now there is so much ignorance on this subject. I have done extensive research on this subject (was forced 2 after being diagnosed)

Here sharing it with you all. retweet it, it may save someone's life.

Masks. A short thread. In June last year my GP advised me that wearing a mask even for a short space of time would be harmful for me on two fronts. One - I have painful rosacea on my face. It’s a horrible condition and it’s lifelong. I can at times look scary!

Putting on a mask simply makes it worse. Two - I have hypertension. Manageable and controlled. GP also advises that mask wearing even for short periods can raise cortisol levels and make them dangerous to me.

On that basis and given the dreadful treatment us non-maskers have to suffer and to appease the abusers I have three times asked my GP to issue me with a letter relating to my conditions.

On each occasion she has said that there is no need. Whilst she won’t admit it straight up, all conversations suggest she’s been told not to. I happen to agree that no-one should need to reveal their medical history to anyone other than medical professionals responsible for me.

I’ve researched mask wearing in relation to what they are supposed to be used for ref *Covid* - I’m no thicko - I prepare risk assessments (and I’m qualified to do so) every day (or did) - and the evidence *for* is weak. Very weak.

In medicine, reckoning with racism includes reappraising the very syntax we use every day. Proud to add my voice w/ @J_Ikeme and @RWGrantMD in this @JAMAInternMed pub addressing:

Does race/ethnicity belong in the first line of the patient

Some background: I’ve struggled with this question since early in medical school

Medical syntax is designed to communicate information in a predictable sequence with key elements prioritized to facilitate efficient communication and formation of an assessment and plan

2/

From preclinical lectures to Qbank questions to clerkship rotations, race/ethnicity was often prioritized in the same sentence as age + gender.

I grew accustomed to reading/hearing: a 70-year-old Black man w/ history of x, a 50-year-old Hispanic woman presented w/ y.

3/

However, when it came time for me to use race/ethnicity, there was always tension. Race/ethnicity are self/socially-ascribed identities that in clinical practice are almost always assumed by providers based on appearance. I was also concerned about the potential for bias

4/

I wondered how my own care would be impacted or not impacted by my ethnicity (Hispanic) – I have light skin so I’m not sure if my doctors would even identify me as such – but how would my care be different if I was presented as a 30-year-old Hispanic male?

5/

🧵 on Importance of correct indication of colonoscopic surveillance studies (English 🇺🇸🇬🇧)
@KM_Pawlak @KMonkemuller @drkeithsiau @JacquelineChuMD @PerelmansPearls @stevenbollipo @SWexner @DrBloodandGuts @ebtapper @DCharabaty @RashidLui @AdvaniRashmiMD @AtoosaRabiee @DrMohdZein

@GI_Guy @RodriguezParra_ @DrHarryThomas @TennysonMD @AustinChiangMD @KralJan @thomaskroner @alinkmd #GITwitter

1/ The implementation of screening and surveillance programs can reduce the incidence and mortality of

2 / But for these to be effective and to guarantee protection against CCR, they must meet a series of conditions. One of them is the correct indication for endoscopic studies for both screening and surveillance.

3 / According to a recent meta-analysis, the minority of patients who undergo colonoscopies have a correct indication, with less than 50% adherence to the surveillance intervals proposed by scientific

The importance of T-cell immunity!
A recent study has found that after one dose of Pfizer’s vaccine, patients had a strong T-cell response, and a boosted antibody response after their second dose. This is good news for many reasons so let’s read up.

This study found that people’s antibodies were moderately effective against the original strain after their first dose of Pfizer’s vaccine, less effective against the B.1.1.7 variant, and were unable to neutralize the B.1.351 variant. Read what I said, that’s only after ONE dose.

However, they had strong T-cell responses against ALL known variants after the first dose. So why is this important? To recap, T-cells stimulate B-cells to make antibodies. Antibodies are just your first line of defense which is what is initiated when you get a vaccine.

It’s our T-cells that are responsible for long-term immunity. When antibodies diminish after your initial inoculation, your T-cells-will tell your B-cells it’s time to produce more antibodies. As long as your T-cells still recognize this virus and inform your B-cells they need

to produce antibodies, the vaccine is still doing its job. Your antibodies will get built up over and over again. Just FYI your TCRs and your BCRs target different parts of the Coronavirus’ spike protein. Antibodies can prevent infection, your T cell-responses ensure that those

is ADHD a mental illness ?

a thread

ADHD is a neurodevelopmental disorder - people with it are born with it and it cannot be altered because it's part of their brain structure and is seen on brain scans. ADHD is also linked to premature births and hypothyroidism during pregnancy, among other things

from the WHO website: "neurodevelopmental disorders are disabilities in the functioning of the brain that can affect behaviour, memory and/or ability to learn."

neurodevelopmental disorders are not caused by external/environmental factors. you cannot *develop* these conditions

mental illness is a general term for a health problem that significantly affects how someone feels/thinks/behaves. mental illnesses cause suffering to those who experience them, as well as often their loved ones. ADHD does not directly cause suffering.

neurodevelopmental disorders are not mental illnesses. ADHD however, does make it more likely for a person to experience mental illness. ADHD can cause dysfunction and stress, but more often than not this comes from lack of accommodation rather than the symptoms themselves.