A lot of people are asking about @NightingaleLDN and the current response. Having spent a lot of time there during the last wave, we are proud of all the energy that went into the response. The NHS in London has adapted and changed since the first wave, with hospitals such as 1/

HELLO: If you pee and every time you finish, your urine looks like this picture, you may have a serious medical illness.

Foamy urine especially if it is persistent and noticeable over time may mean you have a serious kidney problem.

Let’s talk about this today...
RT for others.

What are the features of a normal urine?

A normal urine should have a light yellow colour, painless, odourless (or faint smell), steady stream and should ideally not foam when you pee.

When there’s something wrong, then you see changes in all the above normal features of urine.

For instance if urine becomes very deep yellow, it may mean you are dehydrated;

If urine becomes painful or smells really really bad, it may mean you have an infection;

If urine has a poor stream, especially in a man, it may mean a prostate problem like cancer.

Do you get me?

So today let’s talk about Foamy Urine.

What are the things that can cause urine to suddenly be foamy. As I said in the first tweet, it MAY mean a serious medical illness like a serious kidney problem.

First things first- it does NOT always mean a problem but it may as well.

Now what are the causes of Foamy Urine:

1. SPEED-
If you pee really fast or with a lot of force, it may make your urine more foamy than usual. The speed and force makes the urine generate a lot of bubbles which tend to almost quickly disappear as it is formed in the toilet bowl.

The #RELAx trial has been published today in @JAMA. It was coordinated by Anna Algera. This thread is to explain the rationale, what we did, the findings and the meaning.
The rationale of #RELAx is based on the following

First, there is NO adequate evidence on the level of PEEP in non-ARDS patients. Most of the studies are old, conducted in post-surgical patients (short-term ventilation), and were not powered to detect differences in patient-centered

Second, despite the absence of evidence, the levels of PEEP used in non-ARDS patients increased over years, from 5 to 7/8 cmH2O, probably as a reflection of studies and practice in ARDS

Third, one IPDM showed that higher levels of PEEP could benefit more severe ARDS patients. However, opposite trends (higher mortality and longer ventilation) were found in mild ARDS with higher PEEP (despite not powered to be statistically

Fourth, most of the weaning protocols include PEEP ≤ 5 cmH2O as a criterion for readiness to wean. Theoretically, a standardized liberal strategy of higher PEEP could delay weaning in some

🧵 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

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.

My Neighbour said his hba1c is 7. Everything is fine, he just needs to bring it below 6.9 and he would be fine.
That is just baloney! anything more than 5.6 will result in all kind of complications (Kidney failure,retina failure (blindness) amputations& heart attack etc etc

When i told him the benifits of intermittent fasting and fasting, My neighbour Nitin said, I cannot fast as doctor said i need to eat 5 -6 times a day.

FACT: If you are NOT on any insulin enhancing drugs. you can fast as much as you want. (metformin is OK)

to which he said These drugs r permanent & progressive, you can never stop using them.
FACT: if you can change your diet, you can change your sugar and insulin levels and no longer need these drugs. (advise not aplicable to type 1 diabetics, they wud always need insulin injection

Diet, I am on diet precribed by WHO.
FACT: Fuck WHO, and don't eat carbohydrates. infact another name of diabetes is carb intolerance. You can never acheive 5.6 or lower while eating your rice and roti.