Parham Habibzadeh
@HabibzadehMD
Followers
2,741
Following
1,306
Media
202
Statuses
582
Postdoc Fellow @UMmedschool | Never give up on the things that make you smile. Tweets are mine for education only/not medical advice or endorsements.
Baltimore, MD
Joined May 2020
Don't wanna be here?
Send us removal request.
Explore trending content on Musk Viewer
Olympics
• 3576869 Tweets
Christianity
• 428222 Tweets
Islam
• 424057 Tweets
Last Supper
• 376149 Tweets
Hezbollah
• 231380 Tweets
永山選手
• 116853 Tweets
Majdal Shams
• 112195 Tweets
The Villages
• 87387 Tweets
Druze
• 64840 Tweets
Lebanon
• 64532 Tweets
金メダル
• 57986 Tweets
مجدل شمس
• 57322 Tweets
Cachorrão
• 57236 Tweets
Golan
• 48280 Tweets
Jazz
• 43215 Tweets
Alcaraz
• 37824 Tweets
角田選手
• 35019 Tweets
Medina
• 32192 Tweets
YOU ARE IN LOVE
• 29215 Tweets
C Spire
• 28685 Tweets
Independiente
• 24521 Tweets
Antoine Dupont
• 20862 Tweets
Ledecky
• 17935 Tweets
mafe
• 12687 Tweets
Giannis
• 12262 Tweets
Suns
• 12221 Tweets
Rafa Silva
• 12127 Tweets
Pinned Tweet
Very excited and honored to match
@UPMC
Internal Medicine Residency. A huge thank you to my family and incredible mentors, especially the one sharing this moment with me! Thank you
@UMmedschool
for all the great memories and
@PittDeptofMed
for believing in me.
#MATCH2024
CONGRATULATIONS 💜 To our new class of internal medicine residents here at
@PittDeptofMed
@PittGIM
. We are beyond excited to welcome you to the UPMC family and cannot wait to have all of you here in person to personally congratulate you for this amazing accomplishment!
0
14
62
15
2
59
55-year-old man coming to the clinic for annual health assessment with this finding on physical exam.
What is it called?
DDX?
Mechanism?
🧵🧵🧵👇(1/n)
#MedX
#MedTwitter
#FOAMed
43
122
584
Acute kidney injury is a relatively common (seen in ~10-20% of the patients) side effect of Aminoglycosides but what is the mechanism?
#MedTwitter
#MedEd
🧵🧵🧵(1/n)
12
116
478
A 78-year-old kidney transplant patient presents w/ a 4-day history of fever, cough, dyspnea. CXR shows upper lobe infiltrates w/ "bulging fissures". What is the diagnosis and why are the bacterial colonies mucoviscus?
🧵🧵🧵 (1/n)
#MedTwitter
#MedEd
#IDTwitter
8
67
265
Trying to submit an original article as a research letter
3
17
101
Acanthosis nigricans is a hyperpigmented velvety skin lesion commonly affecting intertriginous sites such as neck and axillae. However, it can appear in other skin areas such as the dorsal surface of the hand. (2/n)
1
7
80
A patient living with HIV with undetectable viral loads for many years asks you if they can stop their antiretroviral therapy (ART). What is the right answer and what is the underlying reason?
🧵🧵🧵👇(1/n)
#MedEd
#MedTwitter
#FOAMed
#IDTwitter
2
27
70
It is most commonly seen in conditions associated with insulin resistance (e.g., DM, obesity, PCO).
A patient with acanthosis nigricans admitted to the Cincinnati General Hospital on March 19, 1961, with diabetic ketoacidosis 👇
(3/n)
3
5
62
Brain MRI of a patient with
#COVID
ー19 and anosmia showing hyperintense areas in gyrus rectus and olfactory bulbs
@JAMANeuro
1
33
62
How to prevent nephrotoxicity?
👉 Select the least nephrotoxic aminoglycoside:
1⃣ Streptomycin (least toxic)
2⃣ Netilmicin
3⃣ Amikacin
4⃣ Tobramycin
5⃣ Gentamicin (most toxic)
👉 Correct HypoK and HypoMg before antibiotic administration
(Ref: UpToDate) (7/8)
2
11
57
Apart from insulin resistance, acanthosis nigricans can also be seen as a paraneoplastic disorder (seen most commonly in association w/ gastric adenocarcinoma).
(4/n)
2
2
56
A Kidney transplant patient comes to the clinic complaining of diarrhea. What is a common reason for GI symptoms in this patient population and what is the mechanism?
A thread 👇👇👇🧵🧵🧵 (1/n)
#MedEd
#MedTwitter
#FOAMed
#MedX
3
15
52
A living WHO guideline on drugs for
#Covid_19
Amazing resource to keep up to date with the latest developments
@bmj_latest
1
18
49
Happy to share our work proposing
#autophagy
as a potential link between
#SARSCoV2
and
#Cancer
just published
@Cancers_MDPI
Here, we explore the potential complications beyond what is currently known as
#LongCovid
Check out the thread to learn more (1/9)
3
16
44
In summary, although insulin resistance is the major cause of AN, it can be seen in a wide range of conditions. In the absence of classic metabolic risk factors, assess the lesions severity and the site of involvement (R/O malignancy) and also ask for family and drug Hx. (12/12)
2
0
41
Prior use of ACEI/ARBs not associated with the incidence of
#COVID19
among patients with
#hypertension
or with mortality or severe disease among those diagnosed with
#COVID19
according to a recent study by
@EmilFosb
et al
@CopCard
published
@JAMA_current
2
20
38
Clues that would favor acanthosis nigricans associated with malignancy include:
1⃣ Severe lesions with rapid spread
2⃣More prominent mucosal lesions
3⃣Presence of other cutenaous manifestations of cancer (e.g., triple palms)
(5/n)
4
4
35
15 y/o with abdominal pain/liver mass. What is the diagnosis and what staining technique has been used in the second slide?
Comment below and find the answer here:
#PathTwitter
#GIpath
#MedEd
2
15
35
The amine groups present on aminoglycoside molecules give them a cationic charge. As a result, they can attach to the anion phospholipids within the cellular plasma membrane (mostly in PCT). (2/n)
1
4
33
Acanthosis nigricans can also be seen as a side effect of various medications (mostly leading to ⬆️insulin resistance).
(6/n)
2
5
32
In conditions associated w/ hyperinsulinemia, ⬆️IGFR1 receptor stimulation on keratinocytes/fibroblasts stimulates their growth and leads to the formation of the typical acanthosis nigricans skin lesions.
(10/n)
1
5
31
"I should have been able to save that person."
Many of us have gone through this. The
#COVID19
outbreak has put us all in challenging situations. You can find many more wonderful illustrations by
@NathanAGray
on
@bmj_latest
Covid-19 communication aids
0
14
30
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are an important component of the guideline-directed medical therapy (GDMT) for heart failure. What is the mechanism of their cardiac benefits?
🧵🧵🧵👇(1/12)
#MedTwitter
#MedTwitter
#CardioTwitter
1
13
28
There, they bind to Glycoprotein 330/Megalin protein and subsequently enter the cells by endocytosis. This protein is also present in inner ear epithelial cells. (3/n)
1
2
27
Klebsiella pneumonia is a gram negative bacteria that is the normal flora of the GI tract. It is a common cause of nosocomial infections in immunocompromised patients with a wide range of manifestations. (2/n)
1
4
31
Recent study published
@ModernPathology
shows absence of
#SARSCoV2
spike glycoprotein expression in placentas from individuals after mRNA
#Covid_19
vaccination. Very reassuring findings supporting the safety of
#mRNA
vaccines to the placental-fetal unit.
0
9
28
16 y/o female with abdominal pain, nausea, and vomiting. Laboratory evaluation shows elevated AST and ALT. CT scan shows right hepatic lobe mass with internal septation. What is the diagnosis?
Learn more:
#PathTwitter
#GIpath
#pathology
#livercancer
2
9
26
16% of hospitalized
#COVID
ー19 patients had at least one thrombotic event with variation by the clinical setting and the type of thrombosis according to a recent study by
@PlateletDoc
and colleagues
@NYUCVDPrevent
published
@JAMA_current
@JAMANetwork
0
17
24
Hypervirulent K. pneumonia strains produce a "hypercapsule" consisting of exopolysaccharides which gives the colonies their classic mucoid appearance. (3/n)
1
3
26
A small amount of gentamicin can also directly enter the cytosol and lead to cell necrosis through massive proteolysis or act on mitochondria triggering the translocation of cytochrome c leading to cell apoptosis. (5/n)
1
3
23
In summary, the mucoid capsule of K. pneumoniae helps the bacteria evade the immune response through ⬇️phagocytosis, ⬇️availability of antimicrobial peptides, ⬇️inflammatory response, and stoping the complement-mediated lysis. (10/10)
1
2
25
The answer is straight-forward: DO NOT STOP!
HIV is notorious for establishing a latent infection in a wide range of cell populations inside body. The lymphoid tissue is the major reservoir. (2/n)
2
0
22
Therefore, as long as we don't have any means to eradicate these latent reservoirs, we don't have a cure and those w/ HIV should continue taking ART. (6/6)
0
1
22
Drug level monitoring or once-daily dosing in certain patients are other potential preventive measures but they are not completely effective. (8/8)
2
2
20
Finally, acanthosis nigricans can also be seen as a part of various genetic syndromes. These syndromes are generally characterized by the production of antibodies against insulin receptor or defects in the insulin/fibroblast growth factor receptors.
(7/n)
1
1
19
Furthermore, gentamicin can itself directly damage the mitochondria and impair cellular ATP production. (6/n)
1
2
18
The endosomes containing gentamicin are subsequently transported to the endoplasmic reticulum where they activate unfolded protein response (UPR) and cell cycle arrest leading to cell apoptosis. (4/n)
1
2
19
As a result, there is a rebound viremia following the discontinuation of the ART originating from these reservoirs. (3/n)
1
1
18
A 78-year-old kidney transplant patient presents w/ a 4-day history of fever, cough, dyspnea. CXR shows upper lobe infiltrates w/ "bulging fissures". What is the diagnosis and why are the bacterial colonies mucoviscus?
🧵🧵🧵 (1/n)
#MedTwitter
#MedEd
#IDTwitter
8
67
265
0
1
18
Recent study published
@Gut_BMJ
reports a robust and specific fecal microbiota-based screening for the early detection of
#PancreaticCancer
💡Very important findings highlighting the role of 🦠🦠 in
#Cancer
etiology, prevention, and even
#treatment
1
7
18
The most characterized example is 2 patients w/ HIV who underwent stem cell transplantation due to hematologic malignancies. Although neither patient had any evidence of HIV following extensive investigation, rebound viremia occurred months after discontinuing ART. (4/n)
1
0
16
How do these lesions form?
It's most commonly seen in association with insulin resistance. So elevated insulin levels could play a role. However, there are other situations where acanthosis nigricans is seen in the absence of hyperinsulinemia (e.g. cancer).
(9/n)
2
0
14
@CLachowiez
@KMirza
Cool! Just found this paper published
@eLife
regarding TP53 copy number expansion in elephants
1
3
15
In malignancy-associated acanthosis nigiricans, ⬆️ levels of transforming growth factor (TGF-α) produced by cancer cells ➡️ interact with EGFR and FGFR ➡️ proliferation of basal epidermal cells ➡️ keratinocytes proliferation.
TGF-α levels ⬇️ following cancer treatment. (11/n)
1
1
13
Recent
@Annals_Oncology
paper shows that patients with
#Cancer
are still susceptible to severe outcomes following breakthrough
#COVID19
.
Those with lymphopenia, comorbid conditions, and hematologic malignancies (vs. solid cancers) are at higher risk.
0
4
13
A patient previously treated for gastric adenocarcinoma w/ nivolumab (3 M ago) now presents w/ dyspnea and cough.
Chest CT: multifocal peripheral and sub-pleural consolidations.
What is the diagnosis and the mechanism of this condition?
🧵👇(1/n)
#MedTwitter
#MedEd
#FOAMed
1
5
15
🆕
#GBDStudy
estimates a shortage of 43 million health workers in 2019 that is more serious in low-income settings.
0
5
14
According to a recent investigation
@JAMAOnc
@JAMA_current
patients with recent diagnosis of
#cancer
(particularly leukemia, non–Hodgkin lymphoma, and lung cancer) are at significantly increased risk of
#Covid_19
infection.
2
4
15
What are the clinical implications of the presence of capsule in hypervirulent strains?
It ⬇️ immune response leading to tissue abscess formation and possible metastatic infection. However, the good news is that they are still susceptible in vitro to cephalosporins. (9/n)
1
2
16
Study shows a stepwise increased risk of atherosclerotic
#cardiovasculardisease
with increasing SBP levels starting from as low as 90 mm Hg among individuals without
#hypertension
or other traditional risk factors
@JAMACardio
@JAMA_current
0
6
14
Most notably, phylogenetic studies later showed that only a few cells (latent reservoirs) were responsible the viremia in both patients. (5/n)
1
0
14
Considering the well-known role of other viral agents in
#Cancer
, this possibility should be explored here as well. You can read about the events leading to such discovery in case of HTLV-1 by
@DrRobertCGallo
in this paper: (8/9)
1
2
13
We hope our work would give impetus to future research on this very important topic. (9/9)
0
3
13
Our hypothesis on the potential effectiveness of acetazolamide in the prevention of acute kidney injury in
#Covid_19
is now published in the European Journal of Pharmacology:
0
3
13
Recent
#GBDStudy
published
@TheLancet
shows that nearly half of
#cancer
related deaths are due to risk factors. The major identified risk factors were smoking, alcohol use, and high BMI (ALL PREVENTABLE‼️).
0
7
14
Excited to see our paper recently published
@Cancers_MDPI
proposing
#Autophagy
as a potential link between
#SARSCoV2
and
#Cancer
ranking on top of the list of "Top Downloaded Papers (Nov 2021 - Jan 2022)"
1
4
12
Our book on the Pathophysiologic Basis of Acid-Base Disorders is now published online. Thank you
@SpringerNature
for highlighting our work.
#springer
@Springer_Shop
@SpringerClinMed
@SpringerMedizin
@SpringerHealth
@SpringerIME
1
4
12
Suboptimal humoral immune response to
#SARSCoV2
vaccination in patients with asymptomatic precursor stages of multiple myeloma and Waldenstrom macroglobulinemia according to a study by
@IreneGhobrial
and colleagues
@DanaFarber
just published
@Cancer_Cell
0
5
12
It should be noted that what we have proposed is a hypothesis that needs to be investigated in laboratory-based, clinical, and epidemiologic studies (7/9)
1
2
12
These complex interactions could overall not only affect the development and progression of
#Cancer
but can also affect response to cancer treatment as we discuss in the paper (6/9)
1
2
12
Increased abundance of bacterial pathogens, including Pseudomonas aeruginosa in the nasal microbiome associate with acute
#SARSCoV2
infection according to a recent study by investigators
@MessaoudiLab
@UCIrvine
published
@CellReports
0
6
13
On the other hand, a growing body of evidence supports extensive interaction between
#SARSCoV2
particles and the host autophagy machinery (4/9)
1
2
11
A 67-year-old female presents with encephalopathy, ataxia, and this finding on physical exam 👇
What is the diagnosis and what is the pathophysiology of this condition?
A thread 🧵🧵🧵(1/11)
#MedTwitter
#MedEd
#FOAMed
2
9
13
But how does the capsule help the bacteria? It has been shown that it can let the 🦠escape phagocytosis by the immune cells. (4/n)
1
0
13
These interactions with the autophagy machinery could as well affect cellular metabolism (5/9)
1
2
11
Rereading Arrowsmith, a 1925 novel by
@NobelPrize
Laureate Sinclair Lewisthe telling the story of an ambitious early-career physician facing many challenges we face during the
#COVID19
#pandemic
@JAMA_current
0
4
12
Furthermore, capsular polysaccharides block the bactericidal activity of antimicrobial peptides by binding them ➡️ act as a decoy reducing the amount of peptides that can reach the bacterial surface. (6/n)
1
1
12
Villous atrophy has been reported in MMF-induced diarrhea. Enterocytes depend partially on IMPDH and its inhibition by MMF could explain direct damage mediated by this drug to the enterocytes in these patients. (8/n)
1
1
10
A study by
@c_gaebler
@NussenzweigL
@PaulBieniasz
& colleagues
@RockefellerUniv
@HHMINEWS
@IcahnMountSinai
published
@Nature
has shown that
#SARSCoV2
antigens could persist in
#COVID19
survivors GI tract for months after the resolution of symptoms (3/9)
1
2
10
Recent study by
@StanfordMed
researchers published
@MedCellPress
shows 💩
#SARSCoV2
RNA shedding for up to 7⃣ months following
#Covid_19
in those w/ mild to moderate symptoms (even after 🫁 clearance!).
0
6
9
Furthermore, the capsule may induce IL-10 production at the site of infection ➡️➡️ down-regulate the pro-inflammatory cytokines. (5/n)
1
1
11
Happy to be a part of this investigation led by
@DariusFakhari
@BostonChildrens
establishing "ATG9A ratio" as a diagnostic marker for AP-4-associated HSP.
This marker could be particularly helpful in the interpretation of novel missense variants.
0
4
10
A recent case series published
@JAMACardio
@JAMA_current
reports a significantly higher burden of neutrophil extracellular traps (NETs) in patients with STEMI and
#COVID19
compared with those without
#COVID19
(median NET density 61% vs 19%).
1
4
9
A study by researchers
@Astarhq
@NUSingapore
published
@Gut_BMJ
identified a lncRNA (NAIL) which forms a positive feedback loop with NFκB signaling and regulates the expression of inflammatory cytokines. A great therapeutic target for
#Cancer
and
#IBD
.
0
3
10
85-year-old man w/ persistent back pain and anemia.
Bone marrow aspiration 👇
What is the diagnosis? What is the role of free light chain assay in the diagnosis of this condition and how does it work?
🧵🧵🧵(1/n)
#MedTwitter
#PathTwitter
#FOAMed
#ASHImageBank
1
4
9
"To wisely live your life, you don't need to know much
Just remember two main rules for the beginning:
You better starve, than eat whatever
And better be alone, than with whoever"
#Khayyam
0
2
8
🆕🔥
@JAMANeuro
Investigation of patients w/
#COVID19
shows axon injuries and microvasculopathy in olfactory tissue (postmortem).
‼️ olfactory dysfunction associated with
#COVID19
may be severe and permanent.
1
3
9
It actually changed my whole life eight years ago!
Hope this cute incidental finding brightens your day as it did mine 🌼
#autopsy
#grosspathology
#gipath
12
26
144
1
0
8
#COVID19
#pandemic
far from coming to an end according to a population-based seroprevalence study from Switzerland by
@silviast9
and her colleagues just published
@TheLancet
Most of the population of Geneva, a hard-hit region, remain uninfected!
0
1
8
Sensitivity of
#COVID19
#antibody
testing very closely related to when the test is performed according to a recent
@CochraneLibrary
@cochranecollab
systematic review:
70% for tests at 8 to 14 days after disease onset and over 90% between 15 and 35 days
0
4
8
Happy to see our paper on the clinical/molecular features of a patient with mitochondrial complex III deficiency selected by
@FrontiersIn
@FrontNeurol
chief editor
@MatthewJFarrer
in Neurogenetics Editor’s Pick 2021 collection
0
3
8
The capsule can also inhibit the complement-mediated bacterial lysis. (7/n)
1
1
9
Another testament of the importance of in-depth genetic/immunologic investigations. A study (n=1) by
@casanova_lab
and colleagues showing Inherited T-bet deficiency in a child with severe mycobacterial disease published
@CellCellPress
0
0
8
What is the diagnosis?
A famous Dutch painter who died at the age of 37 after a lifelong condition eventually leading to congestive heart failure. You can find the patients portraits elegantly demonstrating his own disease progression
@JAMACardio
1
2
8
Overall, MMF is known to be a potent inhibitor of lymphocytes proliferation. It acts through the inhibition of IMP dehydrogenase, an important enzyme in the de novo synthesis of purine nucleotides. (7/n)
1
0
7
In the end, no matter what the exact mechanism is, reducing the dose of MMF or discontinuing it will usually lead to the resolution of diarrhea. (10/10)
2
0
8
Another important piece of evidence showing the effectiveness of universal masking in the prevention of
#SARS_CoV_2
transmission in a study by
@DLBHATTMD
and colleagues
@BrighamWomens
@MassGeneralNews
just published
@JAMA_current
0
1
6
EPICOVIDEHA survey results just published
@BloodJournal
shows that age was the only factor independently associated with the risk of death due to
#COVID19
among vaccinated adult patients with hematological
#cancer
1
3
7
Awake, non-intubated patients with
#COVID19
hypoxemic respiratory failure could as well benefit from prone positioning as shown in a study by a group of researchers
@Columbia
published
@JAMAInternalMed
@JAMA_current
0
7
8
Everyday I meditate upon this, and every night I groan
Why is my own existence to myself the least known?
Whence have I come, why this coming here?
Where to must I go, when will my home to me be shown?
#Rumi
1
1
8
Widening variation in adolescent mortality between countries and by sex according to a recent study published
@TheLancet
Driven by poor progress in reducing deaths in males and older adolescents and expected to become worse due to the indirect effects of
#COVID19
pandemic
1
2
7
One of the most important studies since the pandemic began shedding light on the autoimmune/genetic basis of severe
#COVID19
We have been silent for a while because our lab and the CHGE were entirely focused on finishing 'twin papers' in
@ScienceMagazine
about inborn errors of type I IFN or auto-antibodies to type I IFN in nearly 15% of patients with life-threatening
#COVID19
😀
42
789
2K
0
2
7
Another investigation on the accuracy of diagnostic tests. This time assessing the diagnostic accuracy of unenhanced CT in predicting the outcome of asymptomatic univesicular liver hydatids published
@ESR_Journals
0
2
7
Updated homunculus thanks to a study highlighting brain areas responsible for coordinating complex movements.
❗️These areas are also involved in regulating blood pressure.
#MedTwitter
#MedEd
#neurotwitter
0
5
7
