#MedicalNicotine

348,601 "ever-#snus users had about 60% lower Parkinson's disease risk compared with never-snus users."
https://t.co/YHB9FKkUtQ

30,000 British doctors followed for 60 years: "current smokers at baseline had a 30% lower risk of

All Women are at risk of getting Cervical Cancer. It often affect women over age 30.

Long-lasting infection with certain types of human papillomavirus (HPV) are the main cause of cervical cancer.

HPV is a virus that is passed from one person to another during sex.

A Thread 🚺

More than half of sexually active people might have HPV at some point in their lives, but few women will get CERVICAL CANCER.

Early Screening tests & the HPV vaccine can help prevent cervical cancer.

When cervical cancer is diagnosed early, it is highly treatable &....

2/cont.

associated with long survival and good quality of life.

Most (almost all) cervical cancers are caused by HPV.

There are many types of HPV.
Some HPV types can cause changes on a woman’s CERVIX that can lead to cervical cancer as time goes on, WHILE other types can cause genital

or skin WARTS . HPV is so common that most people get it at some time in their lives.

HPV usually causes no symptoms so you can’t tell that you have it. For most women, HPV might be SELF LIMITING (ie it will go away on its own); However, if it doesn't, there are a chances that

over time it may result to cervical cancer.

OTHER FACTORS CAN INCREASE YOUR RISK of CERVICAL CANCER —
•Having HIV/AIDS
•Smoking.
•Using Oral contraceptives (birth control pills) for a long time (5+ years)
•Having birth to many children (4+ yrs).
•Having many sexual partners

THIS IS A CATCHY & ATTENTION-GRABBING TITLE

Today, the Province will likely announce what zone of the reopening framework we'll shift into as of Tuesday. Whatever is announced, though, doesn't change what we need to do. Why?

Kindly read these 14 tweets & we'll tell you. (1/14)

Fun fact: COVID-19 does not follow us on Twitter. COVID doesn't know, or particularly care, if we're in the Red or Orange zone.

The behaviours of the virus do not depend on the current ‘zone’ of public health restrictions. And, to be perfectly candid, neither should ours. (2/14)

Once upon a time we used to say #WeAreInThisTogether in our messaging. Here's the thing: we are, but we aren't. Not everyone is experiencing this pandemic the same.

Nurses, doctors, paramedics & healthcare workers have experienced things much differently than most of us. (3/14)

Some people have been home & isolated for months, while others haven't been able to stop working.

Business owners & hospitality workers have been on a rollercoaster of openings & closures.

Students, parents, teachers & school staff have had to adapt to going from online (4/14)

to in-person learning (and back again) numerous times.
And this virus has disproportionately affected some groups more than others.

But there's the thing: while our experiences of this pandemic haven't been shared, we do have a shared goal.

And we can reach it together. (5/14)

“Should I give them more fluid?”

Extremely common question during AKI referrals from junior docs.

⛔️ Fluid management is tricky, often misunderstood, & can cause huge iatrogenic harm ⛔️

We try to convey important principles in THREAD 👇

#tipsfornewdocs #medtwitter #tweetorial

Currently too often patients with high creatinine are given too much IV fluid, driven by an AKI ➡️ fluid reflex

We’ve seen 7 litres be given in one shift.

Medics & surgeons, juniors & seniors, it seems everyone loves to reach for extra IV fluid (especially if urine output poor)

Why does huge volume IV fluid ‘resuscitation’ consistently occur?

Lots of reasons, including FALSE beliefs:
🛑 IV fluid always “treats AKI”
🛑 Hypotension = hypovolaemia
🛑 Lactate >2 means fluid deficiency
🛑 Septic patients are very hypovolaemic

The rule with IV fluids and AKI is to remember this 5 word phrase:

💥 💥 Aim for euvolaemia, then stop💥 💥

Fluid status is like Goldilocks - hypovolaemia is bad for the kidneys BUT excess volume is also harmful for renal function and will cause other complications too.

It is easy to say “target euvolaemia” - but we agree it is more difficult to do!

Fluid status assessment is certainly made harder by a belief that we must only rely on a snapshot assessment of examination features which are NOT specific / sensitive / reliable to elicit like.…

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