Catherine Clase @cmclase@qoto.org

@calimari Hello and welcome to Mastodon! I'm Sage, and I love to take photos of tide pool creatures. Here's a picture of a Horned Nudibranch I took recently.

I see the impact of microplastics on every beach I visit. Water bottles, plastic rope, foam containers, even frisbees and sun visors are everywhere. And worse, when you look closely at the sand, it's thousands of tiny specs of plastic.

Sea creatures (and everyone on earth!) are harmed by microplastics. We all have to do our part to eliminate plastic use.
#microplastics #plastics

Still looking for a job. The market's been rougher to me than it's ever been since I came out publicly as trans.
My record?
6 years 0 breaches.
I was part of the security leadership team that helped get 1Password to a 6.8 billion USD valuation.
DFIR, infrasec, infraops, I got you.
Please reach out.

The only "agenda" transgender people have is the right to exist.

After several years
of living with
a dangerous respiratory pathogen
one would think
that we would be prepared
for the threat of another
after all, we have had time
to perfect mitigation techniques
one would think
we would be prepared
yes, one would think that.

Once again a patient with upper respiratory symptoms just told me they do not have Covid because they had a negative home Covid test. A positive test is pretty reliable in saying Covid is present but a negative test (especially if not doing serial tests) does not rule out Covid. Still limit contact with others and wear a high quality mask. Even if not Covid, there is no point in spreading other viruses to others.

Yes, masks reduce the risk of spreading COVID, despite a review saying they don’t.

#COVID19 #masks 😷
https://theconversation.com/yes-masks-reduce-the-risk-of-spreading-covid-despite-a-review-saying-they-dont-198992

This is not a quick two-minute read.
It’s long.
It’s alarming.
It reveals uncomfortable truths.
It’s critical of our default behaviours as humans and the institutions who rule us.
And it’s very, very important.
You should read it, internalise it, and share it.
#ClimateChange #ClimateEmergency #ClimateAction

https://www.theguardian.com/environment/2021/oct/30/capitalism-is-killing-the-planet-its-time-to-stop-buying-into-our-own-destruction

Tracking media coverage of today's action.

CTV/City TV VIDEO:
https://www.cp24.com/mobile/news/protest-outside-toronto-city-hall-today-renews-call-for-more-social-housing-shelter-1.6261363

✨️ Summary:
The Shelter and Housing Justice Network is holding a protest today in front of Toronto City Hall, calling for more supports for social housing and shelter in the city.

The housing and homelessness advocacy network has planned the sit-in protest and vigil for 11:30 a-m, adding there will be speakers at the event.

It comes after last week's extreme cold that brought wind chill values between minus 30 and minus 40 Celsius across much of southern and eastern Ontario.

The City of Toronto said on Friday it had increased capacity at its shelters and warming centres, and had directed workers in the system to not turn anyone away during the extreme cold.

Dept of research that fits my bias

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2800152 in JAMAIM

Intensity of pre-transplant CAD work up (varying from 24 to 56% at centre level) and post #transplant outcomes to 30 days.

Doesn’t matter!

@cmclase @hswapnil pts 1,25 dihydroxyvit D was 40s so I figure can try to suppress that with either fluconazole or hydroxychloroquine off-label for more “targeted” treatment than bispnosphonates. Side note: she has excellent bone density…again would have been great to have a dx of FHH. Checked a ACE level (high of course w/no evidence of disease anywhere…why did I check it??) She agreed to give hydroxychloroquine a shot as a next step... will see if any response. Still needs a cscope done.

@cmclase @hswapnil thanks Catherine
For the input and tips on using mastodon!

I didn’t mention that this patient was heterozygous for a SLC34A3 variant Ser192Leu on the genetic testing. This causes increased risk of hypercalciuria (which are pt doesn’t have) due to low serum phos stimulating calcitriol synthesis. Bialleic cases have been described w/hypercalcemia but not monoalleic cases. I don’t feel this pts case is explained by that mutation but may be contributing https://www.medrxiv.org/content/10.1101/2023.01.21.23284856v1

@cmclase thanks! Trying to see if I’m missing any zebras. With low calcium excretion I thought I’d pick up FHH. Genetic testing neg for FHH. Thought of the pheo zebra (some secrete calcitonin)…plasma metanephrines wnl. Parathyroid scan neg (I know it’s not 100%), i empirically gave cinacalcet and no improvement in calcium. Vit A wnl. Cystatin c eGFR is lower at 38 but don’t think would have hypercalcemia w/secondary hyperpara…

Finally made the move!

Pt in 40s thin, new poorly controlled DM, severe HTN, nephrotic proteinuria, retinopathy, hypercalcemia 12-13. Cr 1.0 Previously healthy but not seeing doc regularly. PTH 40s after repleting vit D. 24 hr urine ca anywhere from undetectable to <150. Pth-rp nl, Pan CT negative for cancer. Calcium still 12s after IVFs in hospital briefly improved it. Pt a little dizzy in general. Has orthostasis, BP 150s sitting to 120s standing. Next steps for hypercalcemia??

Sooner or later, #degrowth *is* coming to our economy and to our society. It simply can't be avoided.

The only question is whether we will choose to enact that transition as smoothly as possible, or instead have it forced upon us by the actions of nature.

The next time you use any navigation device, software or Google Maps thank Dr. Gladys West. Her contributions to the mathematical modeling of the shape of Earth, and her work on the development of the satellite models that were eventually incorporated into  the Global Positioning System (GPS) technology. #BlackMastodon #BlackHistoryMonth

Thanks Robert for the s/o and the work you & ASHRAE are doing to improve building air quality standards. Our mission is to blaze a quiet, cost-effective path to outdoor-levels of COVID safety for indoor air!
---
RT @healthyheating
S/o @cleanairkits looking forward to having these in my hotel and meeting room...going to bring them to our jam session!
https://twitter.com/healthyheating/status/1621195012112547840

Hyponatremia: Diagnostic algorithm
#Nephpearls

👉🏼 https://shop.lww.com/Handbook-of-Critical-Care-Nephrology/p/9781975144098