Maramelia Miranda

8.2K posts

Maramelia Miranda

Maramelia Miranda

@maramd

Neurologist, Vascular Neurology, Neurocritical Care, citizen. Learning, learning, learning.

Brazil Katılım Eylül 2009
904 Takip Edilen1.1K Takipçiler
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Maramelia Miranda
Maramelia Miranda@maramd·
Atenção, amigos. Vejam só o que acontece se vc reduz em 5mmHg, ou 10. Ou 20, ou 40mmHg de sua PA (pressão arterial), se estiver alta... Reduz a 7, 22, 54 e 64% a chance de eventos (moete AVC infarto evento CV em geral...). Tratamento PODEROSO. Não é opinião. É matemática.
SBAVC | Sociedade Brasileira de AVC@SBAVC1

Vejam esse artigo de revisão de Fuchs et al, publicado hoje na Hypertension, com as mais recentes evidências sobre o quão poderoso é o correto tratamento da hipertensão arterial na redução de risco de morte, infarto, AVC, eventos cardiovasculares em geral. Possivelmente,... 🧵

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Maramelia Miranda
Maramelia Miranda@maramd·
@proftulionit Isso. Pagando a professor em universidade federal, para ensinar graduação, media salarial de 10 mil reais bruto. Triste fim da docência universitária federal.
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Professor Tulio
Professor Tulio@proftulionit·
URGENTE! Lula acaba de sancionar lei que prevê a criação de mais de 24 mil novos cargos nas universidades federais. Entre as vagas, estão autorizadas a criação de 13.187 cargos de professores e 11.576 cargos de técnicos administrativos em educação! É pra isso que eu fiz o L!
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디벨로퍼
디벨로퍼@developermin1·
도쿄는 벚꽃 만개
디벨로퍼 tweet media
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Closer_o
Closer_o@Keymong368774·
국립세종도서관 우리나라엔 곳곳에 여러 좋은 도서관들이 많은데,이 국립도서관도 그 중 하나. 국립중앙박물관이 장쾌한 직선미라면, 거대한 책 한권이 놓인듯한 곡선미. 또한 호수공원에 있어, 도서관에서 호수를 바라보며 독서를 할수 있당. <한국에선 도서관을 잘 활용하는게 윤택한 생활의 팁>
Closer_o tweet mediaCloser_o tweet mediaCloser_o tweet media
No_IDentity@NoIDentity33748

세종호수공원 & 국립세종도서관 짧은 산책 후, 밀도 높은 AI 공부 Gems를 활용한 포토 뉴스 & 숏츠 만들기 기획과 워크플로우는 금방 정리했는데, 항상 디테일이 문제다. 허리 아파서 일단 일보 후퇴한다. 1% 만 더 개선되면 좋겠는데, 이것 때문에 또 고생하겠군 시중에 남발하는 ‘10분 자동화’ 다 마케팅이다. 🙄😑 ‘10분 자동화’ 이전의 10일의 시행착오 해야지. 해보자. 하고 만다.

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캣츠파파
캣츠파파@ceolmh3·
불륜이 많은 직업 💯 유흥업이 7위? 이건 너무 의외인데요
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John Mandrola, MD
John Mandrola, MD@drjohnm·
In my three decades of medicine I’ve never had industry reps bring free lunch BEFORE a trial was presented Here’s the flyer BSX passed out “Is your practice ready?” Wow! No mention of CLOSURE AF???
John Mandrola, MD tweet media
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John Mandrola, MD
John Mandrola, MD@drjohnm·
Shocked I am about the explosion of detailed critical appraisal that emerges when trial results upend a common practice. Grin. Double grin.
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Stefano Garzon, MD
Stefano Garzon, MD@stefano_garzon·
I know. CLOSURE-AF is everywhere. The trial was negative. No dispute here. But I disagree with stating that "LAAC doesn't work". Here's what I think of the data.
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Maramelia Miranda
Maramelia Miranda@maramd·
Many insights about the #CLOSUREAF recently published.
Greg Marcus@gregorymmarcus

An important addition to the literature. Interestingly- and let me know if you see things differently- this should not change the practice among those who were already following the @AHAScience @ACCinTouch @HRSonline guidelines: if an AF patient at risk for stroke truly cannot safely tolerate long-term anticoagulation, it remains reasonable (as a 2A recommendation) to place one of these devices. Also, more based on anecdote and common sense, those with a prior LAA clot, particularly if found while on a #DOAC, may still benefit from placement of an LAA occlusion device AND continuation of an anticoagulant. There really never was adequate evidence to support large scale use of these devices as straight-up substitutes for DOACs. @DrJMarine @UCSF @UCSFCardiology @UCSFHospitals @drjohnm @ethanjweiss @DrDave01 @DrRoderickTung @JonPicciniSr

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John Mandrola, MD
John Mandrola, MD@drjohnm·
> 600,000 left atrial appendage devices have been placed NOT NONINFERIOR 👇🏻 Trial is large, nonindustry funded and done in experienced centers in Germany Endpoint had both efficacy and safety components and still did not make non-inferiority I tried to tell you all
NEJM@NEJM

Among patients with atrial fibrillation at high risk for stroke and bleeding, left atrial appendage closure was not noninferior to medical therapy in reducing the risk of stroke, embolism, major bleeding, or death at 3 years. Full CLOSURE-AF trial results: nejm.org/doi/full/10.10… Editorial: Left Atrial Appendage Closure — Another Overused Method in Cardiology? nejm.org/doi/full/10.10…

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NEJM
NEJM@NEJM·
Among patients with atrial fibrillation at high risk for stroke and bleeding, left atrial appendage closure was not noninferior to medical therapy in reducing the risk of stroke, embolism, major bleeding, or death at 3 years. Full CLOSURE-AF trial results: nejm.org/doi/full/10.10… Editorial: Left Atrial Appendage Closure — Another Overused Method in Cardiology? nejm.org/doi/full/10.10…
NEJM tweet media
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Andrew Micieli
Andrew Micieli@MicieliA_MD·
A common referral to neurology. Physician orders MRI for headache or other non-focal symptom, and then general rads reports "findings consistent with demyelination" Patient waits months to see you and is very anxious about report. No hx of transient sx. MRI👇. What do you do?
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Jose Gallucci
Jose Gallucci@josegallucci·
👉Chegamos ao fundo poço. Em entrevista ao G1 a pesquisadora diz que o Editor do grupo @Nature está errado nos argumentos que rejeitaram a publicação de sua pesquisa, que não sabia que precisava registrar o ensaio clínico, mas que agora consulto o ChatGPT p/lhe ajudar.
Jose Gallucci tweet media
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Keşfet

@romilsingh1892 @KimBJstroke @proftulionit @Keymong368774 @RaphaelMAlves @ceolmh3 @grok @drjohnm