🔥The unexpected consequence of too much sitting 🔥

The negatives of a sedentary lifestyle are widely known❗️

One issue that doesn't get mentioned enough is GLUTEAL AMNESIA, also known as the "dead butt syndrome".

Thread - Read more 👇

“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.…

ECTOPIC PREGNANCY

A woman just lost her life due to ectopic pregnancy!

It's a pregnancy in which the embryo attaches outside the womb. It can be life-threatening.

But we can save lives by helping educate women on our Timelines with this.

THREAD 🧵

In the human body, a fertilized egg hardly survives outside the womb. If allowed to grow, it may damage nearby organs & cause severe blood loss.

The bulk of ectopic pregnancies occur in/along the Fallopian tubes.

Some in the ovaries, cervix or a random location in the abdomen.

The usual symptoms of ectopic pregnancy a woman may experience esp. in early pregnancy are;

* Abdominal pain
* Vaginal bleeding, &
* Amenorrhea (missing your period)

Other pregnancy symptoms like breast fullness & occasional nausea may be there too.

But the common DANGER SIGNS of ectopic pregnancy that may signify rupture are;

🔴 Rigid abdomen

🔴 Severe abdominal pain

🔴 Shoulder tip pain, &

🔴 Signs of shock such as cold hands & feet.

With these signs, immediate medical attention is needed to save the woman's life!

Your chances of having an ectopic pregnancy are higher if you have;

1. Previous ectopic pregnancy

2. STI's like gonorrhea

3. Fertility treatments like IVF*

4. Fallopian tube surgeries

5. Pregnancy while using an Intrauterine Contraceptive Device

6. Smoking history! 🚭

Right, screw it. Here's a thread on *that* FBLive by Alex Cairnie about #Govanhill. Lets do a watch-through shall we? (Mind, I'm a resident of Govanhill, and a sociologist. I'm also 5'3, and a visibly queer woman so if half his claims are true I should be living in terror)

00:30: Welcomes viewers and uses points out that his videos are only getting attention b/c they're 'horrific'. Directs folk to his Youtube page. So already clout hunting.

1:08: "I've been warned to stay out of Govanhill. I'm a marked man" (proceeds to use a beanie as a disguise)

1:30 "Laughing and joking aside, here's somebodys front garden." Proceeds to show litter and claim its thrown from windows and this is 'common'. I know a handful of streets with litter issues like this, but its neither common nor unique to #govanhill and other deprived areas.

2:10 "Don't be under any illusion I'm only showing you the bad bits" - only shows you the bad bits.

3:45: He's had offers of help, but hes said no because hes not responsible for 'anybody elses safety' Good lord.

5:01: "Its not that bad. But its not all good either" -Correct

6:00: TW: child abuse - He starts claiming to have been contacted by a health professional and told about child abuse 'in the area'. Huge ethical issues here as the 'professional' who has 'been in the game a long time' is reporting to Facebook Dude and not authorities.

I'm not pro-murdering babies.
I'm pro-Becky who found out at her 20 week anatomy scan that the infant she had been so excited to bring into this world had developed without life sustaining organs.

"Public health" isn't just about vaccinations, clinics and urgent care: it's a holistic discipline that encompasses all the contributors to health outcomes, which include things like housing, employment, transportation, pollution and more.

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A new working paper from @nberpubs estimates the number of US covid deaths that could have been prevented with a coherent, effective eviction moratorium and a ban on utility cutoffs:

The paper, written by a multidisciplinary group of Duke researchers from medicine and economics, found that housing precarity (a risk of losing your home) drove risky behavior that increased the spread of the disease and the resulting deaths.

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For example, it forced people to double-up on lodgings, making social distancing impossible, to say nothing of self-isolating after an exposure. It also drove people to tolerate high-risk workplace conditions, including illegal conditions.

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The authors used regression techniques to control for confounding variables, and used like-for-like counties with different utility and eviction policies to estimate the effect that these had on infection rates.

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