A week ago I voluntarily admitted myself to the hospital to get help bc I am losing weight as a result of increased food intolerances, secondary to my very severe #MECFS. A psychiatrist here decided that im mentally ill, 1/
More from Health
🚨Important changes to lockdown/self-isolation regulations from 5pm
The Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021
£800 'house party' FPN & police can now access track & trace data
https://t.co/k9XCpVsXhC
“Large gathering offence”
As trailed by Home Secretary last week there is now a fixed penalty notice of £800 (or £400 if you pay within 14 days) for participating in an gathering of over 15 people in a private residence
Fixed Penalty Notices double for each subsequent “large gathering offence” up to £6,400
Compare:
- Ordinary fixed penalty notice is £200 or £100 if paid in 14 days
- Holding or being involved in the holding of a gathering of over 30 people is £10,000
Second big change:
Since September has been a legal requirement to sell-isolate if you test positive/notified by Track & Trace of exposure to someone else who tested positive
Police can now be given access to NHS Track & Trace data if for the purpose of enforcement/prosecution
This will make it easier for police to enforce people breaking self-isolation rules. Currently there has been practically no enforcement.
Data says only a small proportion of people meant to be self-isolating are fully doing so.
The Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021
£800 'house party' FPN & police can now access track & trace data
https://t.co/k9XCpVsXhC
“Large gathering offence”
As trailed by Home Secretary last week there is now a fixed penalty notice of £800 (or £400 if you pay within 14 days) for participating in an gathering of over 15 people in a private residence
Fixed Penalty Notices double for each subsequent “large gathering offence” up to £6,400
Compare:
- Ordinary fixed penalty notice is £200 or £100 if paid in 14 days
- Holding or being involved in the holding of a gathering of over 30 people is £10,000
Second big change:
Since September has been a legal requirement to sell-isolate if you test positive/notified by Track & Trace of exposure to someone else who tested positive
Police can now be given access to NHS Track & Trace data if for the purpose of enforcement/prosecution
This will make it easier for police to enforce people breaking self-isolation rules. Currently there has been practically no enforcement.
Data says only a small proportion of people meant to be self-isolating are fully doing so.
Very important that obvious failures with Track and Trace and self-isolation (study late last year said 18% of people complying https://t.co/dhJUZ7Pm0l) are not painted as an enforcement issue. Plainly not. Would just pass buck to police who have almost no capacity to enforce https://t.co/Eb4Kl5Ze0E
— Adam Wagner (@AdamWagner1) January 25, 2021
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
