Before we get too far into 2021, I thought I’d write a thread recapping some of the research that came out of my lab in 2020. Most of this work was led by my talented team of graduate students, Kerrianne Morrison, @kmdebrabander, and @DesiRJones.

DR CHRIS MACKIE (@Healthmac) is London’s Medical Officer of Health and a government advisor.

Yesterday, he said schools being open, “SLOWS the spread of COVID.”

For context, let’s look at 23 other times he misused data or gave a bad unsupported take.

🧵A THREAD🧵

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On December 29 we were dillucidating here if the drops meant "surprise, relatively neutral expression" or "a negative expression, horror" (Remember: https://t.co/J2gjQjAENw ). Well, December 22 drops seem to clarify it. First, the December 29 drop that generated the confusion 1/*

didn't appear in today drops, while several old ones have been posted again. I would say that all December 22 drops regarding facial expression mean and clarify "surprise". 2/*

More 3/*

And more. So, they didn't point to a negative event, just to one that generates surprise. 4/*

All these drops were completed with a Christmas gift one, confirming the surprise neutral meaning and adding a related positive one connected to the surprise. 5/*

“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.…

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