Masks. A short thread. In June last year my GP advised me that wearing a mask even for a short space of time would be harmful for me on two fronts. One - I have painful rosacea on my face. It’s a horrible condition and it’s lifelong. I can at times look scary!
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Now you know I love to sh-t in Harvard. But I also like accuracy. So I decided to go look at Harvard’s catalog to see its lack of military history that this article describes (they only teach history of pets it claims) and what I found shocked me! Shocked me! A thread: 1/
First off, Harvard students literally have multiple sections of military history that they can take listed. (It appears these ones are taught at MIT, so they might have to walk down the street for these) but... 2/
Say they want to stay on campus...they can only take numerous classes on war and diplomacy...3/
They have an entire class on Yalta. That’s right. An entire class on Yalta. 4/
But wait! There is more! They can take the British Empire, The Fall of the Roman Empire for those wanting traditional topics... 5/
\u201cMilitary history\u201d is only in decline if you\u2014like the author & experts in this obnoxious piece\u2014see the subject as a narrowly defined, white dude-oriented, guns & bayonets approach. The field is 1000% better off w/today\u2019s diversity of topics & historians. https://t.co/dUf3OWyVpQ
— Jonathan S. Jones (@_jonathansjones) February 1, 2021
First off, Harvard students literally have multiple sections of military history that they can take listed. (It appears these ones are taught at MIT, so they might have to walk down the street for these) but... 2/
Say they want to stay on campus...they can only take numerous classes on war and diplomacy...3/
They have an entire class on Yalta. That’s right. An entire class on Yalta. 4/
But wait! There is more! They can take the British Empire, The Fall of the Roman Empire for those wanting traditional topics... 5/
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
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