Hospitals in the Capital are overwhelmed.

This isn’t an exaggeration.

Here’s why:

Successive Conservative governments have intentionally underfunded the NHS.

It’s all on record. 1/13

More from Health

$Roscoe B Davis\U0001f396\u2b50\ufe0f\u2b50\ufe0f\u2b50\ufe0f$

So now we have a certified Serologic testing of Red Cross US blood donations to identify SARS-CoV-2-reactive antibodies, and that battery of testing shows widespread presence of SARS-CoV-2-reactive antibodies in donations made between December 2019-January 2020

Gregg Gonsalves
@gregggonsalves

Eight years ago, Spencer Cox died of #AIDS. He had access to #antiretroviral therapy, but in his own struggles with #depression and substance use, he stopped taking them. 1/

Spencer left college, dropped out like me in the 80s, and we both found ourselves in @actupny where we joined the Treatment and Data Committee, doing battle with drug companies, the @US_FDA, the @NIH on a quest to save ourselves and our friends from near-certain death. 2/

Now everyone knows what those dark days before the advent of antiretroviral therapy were like. Waves upon waves of dying friends. A government who couldn't care less for the sick and dying. 3/

All this has happened before, and all this will happen again. AIDS. #COVID19. The next pandemic. The fire next time. 4/

And it changes you. Seeing so much death so young. Seeing those in power turn away from the catastrophe, even joke about it (find, listen to the tape of Larry Speakes in Oval Office w Reagan laughing about AIDS). 5/

Santiago
@svpino

You gotta think about this one carefully!

Imagine you go to the doctor and get tested for a rare disease (only 1 in 10,000 people get it.)

The test is 99% effective in detecting both sick and healthy people.

Your test comes back positive.

Are you really sick? Explain below 👇

The most complete answer from every reply so far is from Dr. Lena. Thanks for taking the time and going through

Really doesn\u2019t fit well in a tweet. pic.twitter.com/xN0pAyniFS
— Dr. Lena Sugar \U0001f3f3\ufe0f\u200d\U0001f308\U0001f1ea\U0001f1fa\U0001f1ef\U0001f1f5 (@_jvs) February 18, 2021

You can get the answer using Bayes' theorem, but let's try to come up with it in a different —maybe more intuitive— way.

👇

Here is what we know:

- Out of 10,000 people, 1 is sick
- Out of 100 sick people, 99 test positive
- Out of 100 healthy people, 99 test negative

Assuming 1 million people take the test (including you):

- 100 of them are sick
- 999,900 of them are healthy

👇

Let's now test both groups, starting with the 100 people sick:

▫️ 99 of them will be diagnosed (correctly) as sick (99%)

▫️ 1 of them is going to be diagnosed (incorrectly) as healthy (1%)

👇

Avraham Z. Cooper, MD
@AvrahamCooperMD

1/15
Why can cefepime cause neurological toxicity?

And why is renal failure the main risk factor for this complication?

The answer requires us to learn about cefepime's structure and why it unexpectedly binds to a certain CNS receptor.

#MedTwitter #Tweetorial

2/
Let's establish a few facts about cefepime:

🔺4th generation cephalosporin antibiotic
🔺Excretion = exclusively in the urine (mostly as unchanged drug)
🔺Readily crosses the blood-brain barrier (so it easily accesses the brain)

https://t.co/rjYG1BfGPR

3/
The first report of cefepime neurotoxicity was in 1999.

A patient w/ renal failure received high doses of cefepime and then developed encephalopathy, tremors, myoclonic jerks, and tonic-clonic seizures.

✅All symptoms resolved after hemodialysis.

https://t.co/u7JLVitQpp

4/
Cefepime neurotoxicity is surprisingly common, occurring in up to 15% of treated critically ill patients (w/ symptoms varying from encephalopathy to seizures).

💡The main risk factors = renal failure and lack of dose adjustment for renal function.

https://t.co/nxbnzSq8AR

5/
What about cefepime induces neurotoxicity?

One clue is that it's not the only antibiotic that causes neurotoxicity, particularly seizures.

This actually is a class effect w/ other beta-lactam antibiotics (including penicillins and carbapenems).

https://t.co/Lf4BhON9IY

Patrick Strudwick
@PatrickStrud

I’m deeply saddened to learn that Dr Joseph Sonnabend, one of the most important figures in the history of AIDS, died yesterday. I spent time with him in 2018 for one of the last interviews he ever gave. Let me tell you about this man and what he did:

Sonnabend was one of the first doctors to raise the alarm. In 1979, while running a sexual health clinic in Greenwich Village, he wrote to the NY Health Dept to warn them of the symptoms he was seeing: low white blood cell counts, enlarged lymph nodes. He didn’t get a reply. 2/

So he kept speaking out. When a patient of his developed a very rare cancer – Kaposi’s Sarcoma – he linked up with a dermatologist at NYU who said that over a dozen gay men had it. Sonnabend knew there was something very wrong. He started working at the lab at NYU — for free. 3/

It was soon after this in 1981 that the New York Times famously reported “Rare Cancer Found In 41 Homosexuals”. The next decade would kill most of Sonnabend’s patients and friends — and all of his lovers. What Sonnabend did was to fight for every single of them. 4/

Want to know who was the first to publish advice to wear a condom? That was Sonnabend. In 1983 he co-authored the first safe sex leaflet to fight AIDS: “How To Have Sex In An Epidemic”. 5/

When this was developed, nothing had UPC codes yet because they'd just been invented.
Back when this mistake was made, There was only one Phone Company, because they hadn't been broken up yet. Ted Bundy was still on the loose. Babe Ruth's home run record was about to fall.

When this bug was developed, Wheel of Fortune hadn't yet aired. No one had seen Rocky Horror. Steven Spielberg was still a little-known directory of TV films and one box-office disappointment. SNL hadn't aired yet. The Edmund Fitzgerald was still hauling iron ore.

WHEN THIS STUPID MISFEATURE WAS INVENTED, THE GODFATHER PART II HAD JUST OPENED IN THEATERS.

So, why does this happen? So Unix (which was only 5 years old at this point) had the good idea of "everything is a file" which mean you could do things like write to sockets, pipes, the console, etc with the same commands and instructions.

Erik Torenberg
@eriktorenberg

1/ Here’s a list of conversational frameworks I’ve picked up that have been helpful.

Please add your own.

2/ The Magic Question: "What would need to be true for you

1/\u201cWhat would need to be true for you to\u2026.X\u201d

Why is this the most powerful question you can ask when attempting to reach an agreement with another human being or organization?

A thread, co-written by @deanmbrody: https://t.co/Yo6jHbSit9
— Erik Torenberg (@eriktorenberg) December 4, 2018

3/ On evaluating where someone’s head is at regarding a topic they are being wishy-washy about or delaying.

“Gun to the head—what would you decide now?”

“Fast forward 6 months after your sabbatical--how would you decide: what criteria is most important to you?”

4/ Other Q’s re: decisions:

“Putting aside a list of pros/cons, what’s the *one* reason you’re doing this?” “Why is that the most important reason?”

“What’s end-game here?”

“What does success look like in a world where you pick that path?”

5/ When listening, after empathizing, and wanting to help them make their own decisions without imposing your world view:

“What would the best version of yourself do”?