Discover and read the best of Twitter Threads about #Pediatric

Most recents (24)

My 3 year old daughter Lila was recently diagnosed with a VERY rare and aggressive type of #leukemia.

👉 It’s potentially treatment resistant… AND

👉 Requires a bone marrow transplant.

A🧵with all the details we have so far 👇

Please @Twitter help me save my little girl. Image
First, some background:

👉 A month ago, Lila was diagnosed with “acute undifferentiated leukemia” (AUL) by her docs at @ChildrensLA

👉 Last week, we found an unrelated marrow donor who’s a perfect “10/10” match (thx to @BeTheMatch ) and they have agreed to donate. 😭
👉 But just yesterday, we learned Lila’s first cycle of chemo failed. 🥺

Before Lila can get the transplant, we have to get her into remission first.
Read 17 tweets
A 14-yo ♂️ lived on a farm: a 1-month history of episodic headaches, vomiting, & papilledema
MR: a multiloculated cyst of the brain (A) with a hypointense rim and small projections in T2 phase (B, arrow)
1/5

DOI: 10.1056/NEJMicm2208104
#neurology #radiology #pediatric Image
Findings suggestive of CYSTIC ECHINOCOCCOSIS.

CT of the body: no other sites of disease.
A craniotomy was performed, during which saline irrigation was used to separate the cyst wall from the brain to avoid rupture.
2/5

DOI: 10.1056/NEJMicm2208104
#IDtwitter #parasitology Image
🔬: an echinococcal laminated membrane lined by a germinal layer with daughter cysts (Panel D, arrows) and protoscolices (inset, arrows) with hooklets (arrowhead).

PRIMARY CEREBRAL CYSTIC ECHINOCOCCOSIS FROM ECHINOCOCCUS GRANULOSUS
3/5

#microbiology #Pathologists #pathology Image
Read 5 tweets
📣#GITwitter #PedsGI

⚕️Join experts @valcohranmd @Subramanian1MD ⚕️& @DCharabaty addressing the long & the short of:

🎯Optimizing care of #ShortBowelSyndrome

🏆🆓 #CME 🔗bit.ly/3wLGPzF
Supported by an edu grant @TakedaPharma
2/#MondayNightIBD #GITwitter #PedsGI #MedEd #MedTwitter #MNIBDWebinar #BonumCE

Earn 🆓 #CME 🎫
ℹ️ 🔗 bit.ly/3wLGPzF

📸 Faculty disclosures & important CME info 👇 Image
3/#MondayNightIBD #GITwitter #PedsGI #MedEd #MedTwitter #MNIBDWebinar #BonumCE

🟠Full CME ℹ️ 🔗bit.ly/3wLGPzF
🟠Make sure you answer the pre-polls! 👉 bit.ly/3JOd7BU

🔴 Where are you in your career?
Read 12 tweets
@MondayNightIBD @DCharabaty @BonumCe @TakedaPharma 2/ #MondayNightIBD #ShortBowelSyndrome #MedTwitter #GITwitter #MedPeds @BonumCe

🟠Earn #CME 🏆on Twitter!
🟠Full CME ℹ️ 🔗bit.ly/3Hgnpcf

📸 Faculty disclosures & important CME info 👇 Image
@MondayNightIBD @DCharabaty @BonumCe @TakedaPharma 3/#MondayNightIBD

💊💉Meds = important 🛠 in mgmt of #ShortBowelSyndrome

💎Antimotility & antisecretory agents frequently used to control stool loss
💎Incl loperamide, diphenoxylate w atropine, codeine, & tincture of opium
💎Most effective ~30 min B4 meals & @ bedtime 🛏
@MondayNightIBD @DCharabaty @BonumCe @TakedaPharma 4/Growth factors also available for #ShortBowelSyndrome
🚦Somatropin (rhGH) approved in SBS
🛑Use largely discontinued due to unacceptable toxicity & modest long-term efficacy

#MondayNightIBD
Read 23 tweets
1/6 Interesting work from Dr. William Encinosa and colleagues, with #Black #children disproportionately affected...

#complications #adverse #drug #events #costs #disparities #multisystem #inflammatory
#syndrome #MISC #children #COVID19 #LongCovidKids

jamanetwork.com/journals/jaman…
2/6 "Did outcomes vary by the number of organ systems affected in #multisystem #inflammatory #syndrome in #children (MIS-C) in 2021?"
3/6 "In this cross-sectional study of 4107 #MISC #hospitalizations, as the number of #organ #systems affected increased from 2 to 6 or more, mortality increased from 1% to 6%, length of stay doubled from 4 to 8 days,..."
Read 6 tweets
1/4 "Using droplet digital PCR, we found #SARSCoV2 #nucleocapsid #RNA in 7 out of 9 #adenoid and 15 out of 22 tonsil formalin-fixed, paraffin-embedded tissue blocks from post-COV individuals, despite #negative #nasopharyngeal swab #PCRs at the time of surgery..."

#pediatric
2/4 "... variation in memory B cell frequencies and serum-neutralizing antibody titers we observed further highlighted heterogeneity of responses that may leave some #children prone to #repeat #infection."

#pediatric #viral #persistence despite #negative #nasopharyngeal #PCR
3/4 "... activated cells in these #tissues after infection may also contribute to delayed or #prolonged #sequelae of #COVID19, including long-COVID-19 and #multisystem #inflammatory syndrome in children,..."

#LongCovidKids #PASC
Read 4 tweets
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
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
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
Read 8 tweets
A 3-month-old ♂️, a dimple at the center of a lumbosacral hemangioma (a): fever & deteriorating condition.

CSF: ⬆️cell count 5717/µL;⬆️protein = 352 mg/dL; ⬇️glucose < 10 mg/dL.

RM (b): ?
1/7

doi.org/10.1016/j.idcr…
#pediatric #IDtwitter #Neurology
RM b): a congenital dermal sinus communicating with the spinal cord.

Enterobacter aerogenes was isolated from CSF and stool cultures

CONGENITAL DERMAL SINUS ASSOCIATED WITH MENINGITIS BY ENTEROBACTER AEROGENES
2/7

#radiology #microbiology #pediatria
Congenital dermal sinus is associated with meningitis caused by atypical pathogens.

Enterobacter aerogenes community-acquired infections associated with congenital dermal sinus are rarely observed.
3/7

#bacteriology #MedTwitter
Read 7 tweets
Resources to study #Neurology

Adams and Victor’s. By far my favourite textbook.
The book is more clinically oriented, coloured with anecdotes and mental models. Reading it feels like seeing a pt in the ward/OPD

#MedTwitter #neurotwitter
It has elements of philosophy, history and is written eloquently.
Whimsical, yet profound, it’s teachings stay with me. Added bonus, my Guru in Neurology finds mention in the text 🙃 I’d recommend this for #mbbs #md and #dm students
Bradley is the standard #textbook in #neurology. A great book, it’s more like #Harrison. Great for information, latest research and management. Essential for the DM #neurology candidate, but also useful for MD #internalmedicine
Read 11 tweets
1) In light of a surge in pediatric deaths following Group A Streptococcus infections, some observers have tried to link this tragic trend with #pandemic lockdowns and other precautions. In this thread, I will try to explain why that is not the case.

montrealgazette.com/news/local-new…
2) Those blaming #pandemic protections for a spike in scarlet fever and invasive Group A strep infections argue children's immune systems were not "challenged" sufficiently during lockdowns. Once precautions were lifted, many kids got sick as a result, according to this theory.
3) "You can get really sick, perhaps more so than you would have normally because your immune system really hasn't been challenged as much recently," pediatric specialist Priya Soni told the New York Times. Makes sense right? Many politicians are now toeing this line.
Read 18 tweets
A 12-MO♀️ girl, immunization for hepatitis B, 2 weeks prior: a rapidly spreading, nonblanching, nonpalpable, purpuric rash over legs & cheeks surrounded by edema, 37.6°C, nontoxic in appearance

Leukocytosis,⬆️CRP
1/9

#dermatology #Emergency #Pediatrics doi.org/10.1093/cid/ci…
The next day, the hemorrhagic rash became palpable
Pharyngeal PCR:➕for enterovirus
🔬 of purpuric lesions: leukocytoclastic vasculitis, & DI studies showed vascular wall fibrinogen deposition, consistent with ACUTE HEMORRHAGIC EDEMA OF INFANCY (AHEI)
2/9

#pediatric #IDtwitter
Typical patient of ACUTE HEMORRHAGIC EDEMA OF INFANCY:
✔️6–24 months of age,
✔️during winter,
✔️nontoxic presentation,
✔️low-grade fever,
✔️abrupt onset of large purpuric skin lesions,
✔️and edema in face and extremities
3/9

doi.org/10.1093/cid/ci…
#MedTwitter #pediatria
Read 9 tweets
A 5-YO♂️ with a history of IgA vasculitis & a pustular nasal lesions had started scabbing after 2 days of systemic glucocorticoids: progressively painful skin ulcerations of L forearm (A), R calf (B) & R foot (C).
1/4

DOI: 10.1056/NEJMicm2204111
#Pediatrics #dermatology
Biopsy samples from all three lesions showed a dense neutrophilic infiltrate with negative tissue cultures.

PYODERMA GANGRENOSUM
2/4

#MedTwitter #Doctor #MedStudentTwitter
Laboratory & radiographic: no signs of underlying systemic disease, such as cancer, inflammatory bowel disease, or autoimmune conditions.

After 8 months of glucocorticoids: the lesions resolved completely.
¾

#resident #pediatric #MedicalStudents
Read 4 tweets
A 17-MO♀️, Morocco: fever, pallor, epistaxis, gingival petechiae, lower limbsedema, & hepatosplenomegaly.

Pancytopenia, hypoalbunemia.
Triglyceridemia, ferritinemia, LDH & fibrinogen:⬆️
PT⬇️
Direct Coombs test:➕

🔬myelogram: ?
1/9

#parasitology #haematology #Pediatrics
Myelogram revealed the presence of leishmania bodies and figures of hemophagocytosis.

VISCERAL LEISHMANIASIS ASSOCIATED WITH MACROPHAGE ACTIVATION SYNDROME
2/9

doi.org/10.1016/j.idcr…
#Pathologists #microbiology #IDtwitter
The patient was put on liposomal amphotericin B and corticosteroid therapy with good clinical and biological evolution.
3/9

#MedTwitter #Doctor
Read 9 tweets
👧de 7 años, picadura de #garrapata (fig.) en el sur de #España: febrícula, astenia, múltiples ganglios linfáticos cervicales laterales y posteriores, y escara negra rodeada de eritema en la región occipital (fig.).
1/5

DOI: 10.1016/j.anpedi.2020.03.010
#pediatría #dermatología ImageImage
La niña fue diagnosticada de linfadenopatía transmitida por garrapatas, TIBOLA (TIck-BOrne LymphAdenopathy).

Claritromicina de 5 días: asintomática un mes después. La escara negra desapareció a las 5 semanas.
2/5

#AtenciónPrimaria #urgencias #MedEd
TIBOLA
✔️enfermedad emergente en Europa
✔️causada mayoritariamente por Rickettsia slovaca (también por R. rioja, R. sibirica mongolotimonae, R. massiliae, Bartonella haenselae y Francisella tularensis) y
✔️transmitida por garrapatas Dermacentor

3/5
#microbiología #microbiology
Read 5 tweets
🧒 20 meses, dermatitis atópica: exantema vesiculoso de base eritematosa en región axilar de 3 días de evolución, febrícula e irritabilidad.
1/6

🖊️Bravo B. @ContinuumAEP @aepediatria continuum.aeped.es/courses/info/1…
#pediatria #infecciosas #Medicina Image
@ContinuumAEP @aepediatria El ECCEMA HERPETICUM (o erupción variceliforme de Kaposi):
📌erupción agrupada vesículo-pustulosa sobre base eritematosa
📌el virus del herpes simple reactivado afecta a grandes áreas de la piel
📌en pacientes con dermopatía previa

2/6
#microbiología #Pediatrics #MIR
@ContinuumAEP @aepediatria El eccema herpeticum puede llegar a ser un cuadro grave.

El niño recibió aciclovir oral y evolucionó bien
3/6

#dermatología #pediatric #EducaciónMédica
Read 6 tweets
#COVID19 #VariantDashboard - #UnitedStates

TOP lineages (15-DAY TRENDS):

17.0% BA.5.2.1
10.8% BA.5.2
10.7% BA.4.6
6.9% BA.5.1
2.7% BF.7
2.6% BF.10
2.5% BA.5.5
2.2% BQ.1
2.1% BA.5.6
2.1% BF.5

Tracker: tinyurl.com/mryj4uu7

#OmicronUpdates 10/20/22
1/n
Sequence count by US State

Share of sequences with sample collection dates in the last 15 days.

2/n
15 of the 2729 sequences are from opt-in voluntary airport screening with sample collections dates in the last 15 days

3 BQ.1.1 (NY, GA, CA)
1 BQ.1 (CA)

#MaskUp in✈️🛳️🚍🚉etc

3/n
Read 20 tweets
#COVID19 #VariantDashboard - #UnitedStates

TOP lineages (15-DAY TRENDS):

18.5% BA.5.2.1
15.4% BA.5.2
12.0% BA.4.6
10.3% BA.5.1
3.6% BF.10
3.2% BA.5.5
2.6% BA.5.2.9
2.6% BA.5.6
2.0% BA.5
2.0% BF.7

Tracker: tinyurl.com/mryj4uu7

#OmicronUpdates 10/06/22
1/n
Top circulating lineages (#15DayTrends)

80% BA.5*
12% BA.4.6*
2% BF.7*
1.5% BA.4*
1.3% BA.2.75*
1.1% BQ.1*
0.9% BQ.1.1*
0.3% BA.2.3.30*
0.1% XBB*

2/n
.@CDCgov updated variant proportions estimates on 9/30/2022



3/n
Read 14 tweets
#COVID19 #VariantDashboard - #UnitedStates

TOP lineages (15-DAY TRENDS):

20.4% BA.5.2.1
13.4% BA.5.2
12.7% BA.4.6
9.9% BA.5.1
3.8% BF.10
3.5% BA.5.5
2.8% BA.5.6
2.7% BA.5.2.9
1.9% BF.7
1.9% BA.5

Tracker: tinyurl.com/mryj4uu7

#OmicronUpdates 10/05/22
1/n
Top circulating lineages (#15DayTrends)

79.6% BA.5*
12.72% BA.4.6*
1.94% BF.7*
1.59% BA.4*
1.22% BA.2.75*
1.16% BQ.1*
0.78% BQ.1.1*
0.32% BA.2.3.30*
0.12% XBB*

2/n
.@CDCgov updated variant proportions estimates on 9/30/2022



3/n
Read 14 tweets
#COVID19 #VariantDashboard - #UnitedStates

TOP lineages (15-DAY TRENDS):

22.0% BA.5.2.1
13.6% BA.5.2
11.0% BA.4.6
9.9% BA.5.1
3.7% BF.10
3.5% BA.5.5
3.0% BA.5.6
2.4% BA.5.2.9
2.1% BF.7
2.0% BA.5

Tracker: tinyurl.com/mryj4uu7
#OmicronUpdates 10/04/22
1/n
Top circulating lineages (#15DayTrends)

81.6% BA.5*
11% BA.4.6*
2.1% BF.7*
1.2% BA.2.75*
1.5% BA.4*
1.2% BQ.1*
0.5% BQ.1.1*
0.3% BA.2.3.30*
0.04% XBB*

2/n
.@CDCgov updated variant proportions estimates on 9/30/2022



3/n
Read 14 tweets
#COVID19 #VariantDashboard - #UnitedStates

TOP lineages (15-DAY TRENDS):

21.4% BA.5.2.1
13.6% BA.5.2
10.9% BA.4.6
9.9% BA.5.1
3.9% BF.10
3.5% BA.5.5
3.0% BA.5.6
2.2% BF.7
2.2% BA.5.2.9
1.8% BA.5

Tracker: tinyurl.com/mryj4uu7
#OmicronUpdates 10/03/22
1/n
Top circulating lineages (#15DayTrends)

81.7% BA.5*
10.9% BA.4.6*
2.2% BF.7*
1.5% BA.2.75*
1.4% BA.4*
1.4% BQ.1*
0.5% BQ.1.1*
0.2% BA.2.3.30*
0.02% XBB*

2/n
.@CDCgov updated variant proportions estimates on 9/30/2022



3/n
Read 15 tweets
#COVID19 #VariantDashboard - #UnitedStates

TOP lineages (15-DAY TRENDS):

23.2% BA.5.2.1
13.5% BA.5.2
10.6% BA.5.1
10.0% BA.4.6
4.0% BF.10
3.3% BA.5.5
2.8% BA.5.6
2.4% BA.5.2.9
2.2% BF.7
2.0% BA.5

Tracker: tinyurl.com/mryj4uu7
#OmicronUpdates 10/02/22
1/n
Top circulating lineages (#15DayTrends)

83.7%BA.5*
10% BA.4.6*
2.2%BF.7*
1.5%BA.4*
1.2%BA.2.75*
0.5%BQ.1*
0.3%BA.2.3.30*
0.4%BQ.1.1*

2/n Image
.@CDCgov updated variant proportions estimates on 9/30/2022



3/n
Read 15 tweets
#COVID19 #VariantDashboard - #UnitedStates

TOP lineages (15-DAY TRENDS):

22.18% BA.5.2.1
12.64% BA.5.2
10.88% BA.4.6
10.02% BA.5.1
4.19% BA.5
3.63% BA.5.5
3.23% BA.5.6
3.04% BF.10
2.32% BA.5.2.9

Tracker: tinyurl.com/mryj4uu7
#OmicronUpdates 09/27/22
1/n
Top circulating lineages:

82.4% BA.5*
10.9% BA.4.6*
2.7% BA.4*
1.4% BF.7*
0.8% BA.2.75*
0.7% BQ.1* 👀
0.2% BQ.1.1*👀
0.3% BA.2.75.2*
0.05% BA.2.3.20*
0.02% BJ.1*

2/n
.@CDCgov updated variant proportions estimates on 9/23/2022



3/n
Read 18 tweets
#COVID19 #VariantDashboard - #UnitedStates

TOP lineages (15-DAY TRENDS):

22.33% BA.5.2.1
12.87% BA.5.2
10.53% BA.4.6
10.33% BA.5.1
3.71% BA.5
3.69% BA.5.5
3.43% BA.5.6
3.11% BF.10
2.67% BA.5.2.9
1.59% BF.5

Tracker: tinyurl.com/mryj4uu7
#OmicronUpdates 09/26/22
1/n
Top circulating lineages:

82.62% BA.5*
10.53% BA.4.6*
2.68% BA.4*
1.45% BF.7*
0.94% BA.2.75*
0.62% BQ.1* 👀
0.20% BQ.1.1*👀
0.25% BA.2.75.2*
0.05% BA.2.3.20*
0.03% BJ.1*

2/n
.@CDCgov updated variant proportions estimates on 9/23/2022



3/n
Read 17 tweets
#COVID19 #VariantDashboard - #UnitedStates

TOP lineages (15-DAY TRENDS):

21.86% BA.5.2.1
12.79% BA.5.2
11.39% BA.4.6⬆️
10.89% BA.5.1
3.83% BA.5
3.55% BA.5.5
3.13% BA.5.6
3.02% BF.10
2.55% BA.5.2.9
1.59% BF.5

Tracker: tinyurl.com/mryj4uu7

#OmicronUpdates 09/25/22
1/n Image
Top circulating lineages:

82.23% BA.5*
11.39% BA.4.6*
2.35% BA.4*
1.37% BF.7*
1.04% BA.2.75*
0.67% BQ.1* 👀
0.21% BQ.1.1*👀
0.18% BA.2.75.2*
0.05% BA.2.3.20*
0.05% BJ.1*

2/n Image
BA.5* group of lineages have outcompeted all other circulating lineages in the USA.

@CDCgov updated variant proportions estimates on 9/23/2022



3/n
Read 17 tweets

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