@yudisthra @jordy_bc @mike_johansen @hswapnil @LaurieTomlinson @cmclase As a HF doc I will say that we see euglycemic DKA pretty commonly in patients admitted frequently become NPO for cath, abdominal ultrasound etc. The issue here is not dehydration but rather that decreasing CHO intake and the glycosuric effect of SGLT2i lead to low serum glucose levels that fail to stimulate insulin release from the pancreas, hence the ketosis.
@jordy_bc @mike_johansen @hswapnil @LaurieTomlinson @cmclase in the absence of studies I withold it in patients with dehydration or a risk of dehydration which I may not be able to correct. (like Dengue). I tell my patients to withhold if they have diarrhoea or vomiting. And to avoid unnecessary referrals, I tend to tell surgeons to withhold SGLT2i at least 3 days before surgery
@mike_johansen @hswapnil @LaurieTomlinson @cmclase agree, though hard to do since holding them is almost ubiquitous unless someone forgets to (which implies other aspects of care may be similar) or the surgery is extremely quick/low risk/not requiring NPO status (e.g., bedside procedure?) which carries different risks than surgeries that typically “merit” holding
Never forget, a 13-year study of a dozen cities found that protected bike-lanes led to a drastic decline in fatalities for ALL ROAD USERS. And painted bike-lanes? No safety improvement at all. As for sharrows, it’s safer to NOT have them. Via #StreetsblogUSA, read their article. #bikelanes #bikes #cities #transportation #mobility #sharrows #infrastructure #urbanplanning
https://usa.streetsblog.org/2019/05/29/protect-yourself-separated-bike-lanes-means-safer-streets-study-says/
Hi #introduction from me..!
I'm a Prof of Operational Research at UCL & member of Independent SAGE.
As such, I've been tweeting about Covid for 2.5 yrs now so expect more of that here!
Plus occasional forays into politics, women in science, general science & stuff about London.
Hope I get the hang of it soon!
"So why are so many kids experiencing severe illness from seasonal viruses?
Emerging evidence suggests COVID-19 may be to blame, Furness says. “COVID, like many viruses, harms the immune system as part of its strategy”"
‘Immunity debt’ is ‘misinformation’
https://globalnews.ca/news/9272293/immunity-debt-covid-19-misinformation/
#introduction #Nephrologist and #epidemiologist, Associate Professor at #UCSDNephrology Interested in #ADPKD, #biomarkers, #uromodulin, #FOAMEd, social determinants of health
Migrating over to #MedMastodon so don’t be alarmed if I re-follow you. 😀
Lecture by Harvard's Justin Feldman 🧠(https://scholar.harvard.edu/jfeldman)
How to Hide a Plague: How Elite Capture and Individualism Made Covid Normal
https://www.youtube.com/watch?v=OlFQ26SpGM0&t=1s
"This lecture will argue that the failures of the US pandemic response were mainly driven by economic elites who used their influence to undermine public health protections."
#Introduction #Nephrologist interested in all things Haemodilaysis especially vascular access and home HD. Also CKD epidemiology. Member and Past Steering Committee CKD Prognosis Consortium. Wannabe #Biostatistician. #Kiwi in Australia.
@hswapnil @LaurieTomlinson @jordy_bc
Yes and thank you for all those refs - will incorporate!
Thinking #SickDayRules for #CKD need a rethink!
@cmclase @LaurieTomlinson on RASi - what I find fascinating is data from the COVID RAS studies, eg BRACE CORONA, REPLACE COVID @jordy_bc - and soon CLARITY
None of them show benefit of course, but it’s 🤯that continuing RASi in hospitalized COVID, or even starting RASi (CLARITY) didn’t cause harm.
We should really rethink sick day rules!
More on #SickDayRules
And this one by @LaurieTomlinson herself
shows higher incidence rate ratio for gastroenteritis (IRR 43, compared with baseline) compared with LRTI and UTI s as risk of #AKI in new users of anti-hypertensives
No evidence of a difference in #AKI risk #RASi vs other agents for gastroenteritis or LRTI (interaction p >=0.78) weak evidence for UTI (interaction p=0.02; not robust in sensitivity analysis)
Reading about #SickDayRules and revisiting this very useful paper, thanks @LaurieTomlinson
#CJKHD
https://journals.sagepub.com/doi/abs/10.1186/s40697-015-0044-y
OOPS! I joined the wrong #mastodon server! A guide to changing instances:
1. create a NEW account at the instance you want to join.
e.g. use this link to create a #MedMastodon account
https://med-mastodon.com/invite/4aoetrX7
2. login to your OLD account
3. click "preferences" on the right menu
4. click "account"
5. scroll until you see "moving to a different account" & click "configure it here"
5. fill in your NEW account handle & PW
6. click "Move followers" button
Congrats you've moved to your NEW account!
RT @MTaylorNDP@twitter.com
Today I sent a letter to Minister Jones asking her to help McMaster Children’s Hospital. McMaster is facing a crisis with the recent spike in viral illness, and their occupancy is at 140%. Our community needs support from this gov’t, and we need it now. Our children can’t wait.
🐦🔗: https://twitter.com/MTaylorNDP/status/1590873971196674048
#Introduction: I’m a #nephrologist from Sydney, Australia and a Research Fellow at The George Institute for Global Health. I am a trialist having been involved in the reporting of CANVAS & CREDENCE & serve as Secretariat of the SGLT2 Trialists Consortium. Methodological interest:
evaluating surrogate endpoints for CKD progression for trials through CKD-EPI Consortium. Clinical interests: Hypertension, glomerular diseases, heart failure prevention
I’m a professor of medicine at McMaster University #MacDeptMed, #McMasterU
Clinically, I work as a #KidneyDoctor (#Nephrology)
I’m an associate member of #HEI (#Epidemiology) at #McMasterU
I’m a member of the Centre of Excellence in Protective Equipment and Materials (#PPE, #N95, #CEPEM) at #McMasterU
My #Research is in #KidneyDisease #KidneyEpi (#CKD, #Potassium, #CKDProgression) and #Masks
I’m a scientific editor with more than 20 years experience.
I’m editor-in-chief of https://maskevidence.org/ which curates evidence on #BetterMasks and #MasksWork For the pandemic, we need #SystemsApproaches because #CovidIsAirborne and #CovidIsNotOver. #DoAllTheThings #ventilation #filtration #PaidSickDays #BringBackMasks #WearAMask #MasksSaveLives #MaskeAuf #MaskUp #MaskMandate #MaskMandateNow #CovidLong #LongCovid I’d like to see #KidneyVerse as the tag to find others with interest in #KidneyHealth and #KidneyDisease. #AskKidney #AskRenal Also trying to be #LGBTQ2 ally, working on #EDI #Equity, interested in #SocialJustice #UrbanPlanning. Treaty 3|Dish with One Spoon, Turtle Island; Hamilton ON Canada. She/her