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Prikvačeni tweet
It's a new year, time for a new tweetorial! This one is for all of the amazing
#tweetiatricians taking care of adolescent girls. 14yo female presents to primary care with a complaint of fatigue. Labs are ordered and hemoglobin is 6.0. She describes periods as "fine" 1/nPrikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Never underestimate Kansas City.
#SuperBowl
#theystillneedanewmascotHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Trying to clean up this morning and getting some sass from my 5yo. Me: don’t be cranky with me 3yo: yeah, just be cranky with yourself!pic.twitter.com/ly6WZH0K08
Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Bucket list: Retweet by my twitter hero
@ProfMakris
https://twitter.com/profmakris/status/1223695214088544256 …Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Given this, and the fact that iron causes many side effects (mostly gastrointestinal), daily or QOD dosing is optimal. (My patients tend to end up confused and forgetting doses with QOD) Save your patients $ and side effects while improving efficacy! Win win! 9/fin
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Another study in Blood supports every other day dosing and lower daily doses (40-80 mg Fe) based on duration of hepcidin response and fractional absorption. …https://www-ncbi-nlm-nih-gov.proxy.lib.umich.edu/pubmed/26289639/ … 8/n
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This study in the Lancet demonstrated this in women, as those taking divided doses had increased hepcidin and decreased absorption. …https://www-ncbi-nlm-nih-gov.proxy.lib.umich.edu/pubmed/29032957/ … 7/n
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So back to deficiency and supplementation. Patients who are iron deficient have low hepcidin and are primed for absorption. However, giving large frequent doses of iron increases hepcidin so absorption decreases. 6/n
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Hepcidin is also inc in inflammation and infection. This is thought to be a host defense to limit iron availability to microorganisms. So all that is to say that our body has evolved an elegant system to avoid too much or too little iron and the accompanying problem. 5/n
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Hepcidin is homeostatically regulated by iron and erythropoietic activity. Iron excess
hepcidin production which in turn inhibits further absorption.
Iron deficiency
hepcidin leading fo improved absorption. 4/nPrikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
And deficiency causes overload, as in hemochromatosis! These phenotypes occur bc hepcidin inhibits intestinal absorption and release of iron from macrophages recycling old RBCs. To understand why this matters for dosing we need to look at the regulators of the regulator. 3/npic.twitter.com/t6AUT0cZdr
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It all goes back to a little hormone called hepcidin, which is the primary regulator of iron absorption. Hepcidin is mainly produced in hepatocytes, encoded as a propeptide and following processing, circulates in plasma. Overexpression causes iron restricted anemia... 2/n
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Based on a recent tweet about iron dosing, I’ve had a few requests for a
#Tweetorial.#hemetwitter Iron deficiency is relatively frequent and seen by all types of physicians. For years, iron supplements were given multiple times a day. So why the change? 1/nPrikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Shematologist, MD proslijedio/la je Tweet
Why do we have to pay to park at work?
is this ‘normal’ for any other professions outside of academia? Asking for a friend. Me. I’m the friend. #AcademicChatter#AcademicTwitterHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Me when I order a Diet Coke and am brought a Diet Pepsi.
#notdrinkingthat@CocaColaCopic.twitter.com/9U2ozJLRv4Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
I don’t know who needs to hear this but there is no reason to ever dose iron more than once daily.
#hemetwitter#hepcidinwillwinHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Such an important topic! Thanks
@BloodJournalhttps://twitter.com/htrsfellows/status/1222998406873800705 …
Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Shematologist, MD proslijedio/la je Tweet
Thank you Dr Tyler Buckner for a great discussion on pain today for
#BloodStreamMedia’s upcoming#PainPod! Nice getting to hear how you think about and reflect on experiences with patients in pain.
#hemophilia#haemophilia#vwd#bleedingdisorders#chronicpain#rarediseasepic.twitter.com/9L14yV86pU
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Shematologist, MD proslijedio/la je Tweet
This
#tinylovestory from@nytimes spoke to me. I never thought I would consider letting a 3 yo get a pedicure. But#pedpc teaches, every day is precious. It's hard to shake it when you leave the hospital. Sometimes you just want to spoil them.#motherhood#womeninmedicinepic.twitter.com/UbAn6rFwV4
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Something that bothers me way more than it should: Restaurants that refill Heinz ketchup bottles with non Heinz ketchup. I mean really?pic.twitter.com/3feVob3hyW
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Opening presents at Christmas in order of age. 5yo: I’m the youngest of the grown ups!
Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi
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