John W. Downs MD MPH
@downsjw2000
Internist, #OccEnvMed physician, and medical toxicologist ☠️. Army doc. No exposure➡️No effect. Opinions my own.
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1/ Toxicologists are familiar with loperamide toxicity, but this hasn’t spread as much to other specialities. Thus, my 1st attempt at #tweetorial for #medtwitter . H/T to @jmmarraffa & @DavidJuurlink & @Pete_Wu for their earlier writings. Thxs to @officialdrk12 for the idea
It’s October - hockey season - so let’s talk about a hockey/pulmonary case: A previously healthy 17yo presents with dyspnea, frothy sputum, & orthopnea that began after playing hockey. In the ED he is tachycardic, tachypneic, mildly hypoxic. He has crackles bilaterally. Dx? 1/
Thanks to @ZiadKazzi and @Em2Kiernan for having me yesterday for med tox academics at Emory to talk about intersection of toxicology, epidemiology, and policy in the glyphosate cancer controversy.
Caffeine related "Charged Lemonade" death in someone with a congenital Long QT syndrome? cnn.com/2023/10/23/bus…
Sending text messages and emails does not replace being present at a leader- go see and talk to the people you lead. If your a leader and people don’t recognize you that’s a problem #Presence
MedTox Fellows. Remember hexavalent chromium salts as cause of nasal septal perforations for board exams.
Causes of Nasal Septal Perforation ▶️Cocaine use ▶️Prior trauma/surgery ▶️Granulomatosis w/ Polyangiitis ▶️Sarcoidosis ▶️Complication of infection (fungal sinusitis) ▶️Complication of malignancy ▶️Others #Neurosurgery #ent #radres #futureradres #MedTwitter #NeuroTwitter
MedTox Fellows: Xylazine, an alpha2 agonist like clonidine, is commonly found in illicit drugs (varies across US). FDA reports associations with skin necrosis at injections sites (tinyurl.com/5yjpbw65), and many claims such as:
Causes of Nasal Septal Perforation ▶️Cocaine use ▶️Prior trauma/surgery ▶️Granulomatosis w/ Polyangiitis ▶️Sarcoidosis ▶️Complication of infection (fungal sinusitis) ▶️Complication of malignancy ▶️Others #Neurosurgery #ent #radres #futureradres #MedTwitter #NeuroTwitter
What if the robot knows this is a bad CCB overdose presenting as a sepsis mimic, and insulin truly is the answer 😮
machine learning indicates that insulin is more important than antibiotics for treating sepsis 🙄🤭😂
Rubbing camphor on your chest may help ease a cough, but ingesting it can lead to dangerous neurological instability. Credit: Dr. Aaron Bola #MedTwitter #medicine #emergencymedicine
We had so much fun at the South Hill Chamber of Commerce Fall Crawl event on Saturday!🎃 Catch us in Dinwiddie, Lunenburg, and Midlothian this week!☠️ Got an event that you'd like for the Virginia Poison Center to attend? Reach out to us at [email protected]
Here's my comparison of the 2 vasodilator scavengers used for vasopressor refractory distributive shock: 🟥hydrocobalamin vs 🟦methylene blue Which has more evidence? What are the pros/cons? If you want to learn more I'll be giving a talk on this at #ResusX next week! #FOAMed
Does your house have lead-based paint?🏠 #DYK many homes built before 1978 contain lead-based paint on both interior and exterior walls? When lead-based paint gets old, it can start to peel, chip, or crack and become a hazard. #LeadFreeKids #NLPPW2022 epa.gov/lead/protect-y…
Here’s a story about grit, determination, and the best of @ArmyMedicine. When people ask us— Why #MilPeds? Why NCCPeds?— this is one of our reasons (and worthy of our 1st ever 🧵) 1/6
MedTox Fellows: All of the plants, below, can cause tachyarrhythmias, bradyarrhythmias/blocks and bidirectional ventricular tachycardia. Four plants also cause hyperkalemia. Which does NOT cause hyperkalemia? @toxandhound #FOAMed #FOAMtox
Am aware of 4 NaNO2 poisonings from internet-purchased product in suicides/attempts in Phoenix area over last few yrs; undoubtedly are more. We train medics to carry & use methylene blue, but recognizing MetHbemia in apneic comatose patient without hx of ingestion is difficult.
Last Friday, CBS cancelled a segment about our clients suing Amazon for selling suicide kits to their now deceased kids. CBS’ cowardice gave me renewed clarity about how urgent this litigation is. 🧵@naomi_leeds 1/
🚨DON'T TAKE THE CHALLENGE🚨 Capsaicin is the compound found in spicy peppers that is part of the Paqui "One Chip Challenge." Read more: today.com/parents/parent… Call Poison Help at 1-800-222-1222 today if you have questions or concerns! #onechipchallenge2022 #Poisonhelp
💊 October is #NationalMedicineAbuseAwarenessMonth. Tips to help you: ✅Read all medication labels & warnings ✅Look for the active ingredient ✅Follow the directions ✅Ask your physician or pharmacist to explain the medication ➡Call us with questions 1-800-222-1222
No one more deserving of this #Teaching award! LCDR (Dr.) Robinson is the best! @AcpNavy @NavyMedicine @USUhealthsci @ACPinternists
LCDR Sara Robinson was recognized as the 2021-2 Navy ACP WRNMMC Teaching Faculty of the Year at IM Noon Report while she was on IM wards! One of her MULTIPLE awards! #LadiesOfID @AcpNavy @carlie_cerne @RessnerRose @AliceBarsoumian @brianheartseli1 @YunHeather @CalvanoTatjana
“Six human beings, all of them my patients, one of them my best friend, are dead because they took medicine that I prescribed for them,” one doctor wrote. slate.com/news-and-polit… via @slate
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