Karen Wingartz Small, MD

Uveitis Specialist #Ophthalmology #Uveitis, Manual Small Incision Surgeon, Proud Grandma, Dog Mom, Trained at @Rensselaer @LSU #DrSmallIncision #NeverTooSmall

[Karen Wingartz Small, MD @SmallWingartz]

@Nipi_220 67

[Karen Wingartz Small, MD @SmallWingartz]

@Nipi_220 16 -
6 front, 6 back, 2 arm holes, neck & waist

[Karen Wingartz Small, MD @SmallWingartz]

@elonmuskTN 19

[Karen Wingartz Small, MD @SmallWingartz]

@MySystolic Looks awesome. What’s the catch? So spicy that your eyeballs fall out?

[Karen Wingartz Small, MD @SmallWingartz]

@lizbutler @DGlaucomflecken Patchy redness like that is usually subconjuctival bleeding from straining. Dry eyes has redness that looks like lots of enlarged, angry blood vessels. #NeverTooSmall

[Brief19, your daily roundup of SARS-CoV-2. @Brief_19]

This study was a phase IIb randomized clinical trial comparing:

1. low dose CQ (450 mg BID, then QD for 4d) vs
2. high dose CQ (600 mg CQ BID 10d)

Primary outcomes: safety and efficacy of CQ

[Karen Wingartz Small, MD @SmallWingartz]

Very pleased to see great scientific studies happening in the midst of chaos. Real heroes saving lives!

[Brief19, your daily roundup of SARS-CoV-2. @Brief_19]

The trial was stopped because of this.

Halted for harm.

This is a huge statement.

Because of the higher rate of death in the high dose CQ group, the data and safety monitoring board *immediately* stopped the trial and patients were no longer allowed to receive high dose CQ.

[Brief19, your daily roundup of SARS-CoV-2. @Brief_19]

Regarding DEATHS:

27.2% of patients died ~ similar to historical cohorts in 2 recent major studies of pts not getting CQ...

MORTALITY:
High dose CQ: 39%
Low dose CQ: 15%

Odds Ratio, 3.6; 95% CI, 1.2-10.6

Even in exploratory multivariable regression:
OR 2.8; 95% CI, 0.9-8.5

[Brief19, your daily roundup of SARS-CoV-2. @Brief_19]

Regarding the safety of CQ:
Patients who received high dose CQ had prolonged QTcF > 500 milliseconds on ECG, compared to the low dose CQ group.

High dose CQ vs Low dose CQ:
18.9% vs 11.1% in all patients
24.1% vs 3.6% in PCR confirmed #covid19 patients

[Bunsen, Beaker, Bernoulli & Brix @bunsenbernerbmd]

@dog_feelings By crushing our humans with love we calm them and remove their stress. They then breathe and sweat different chemicals which we can detect and we know that our smushing is working. Also. We get pets. Win win. ❤️

[Jeremy Faust MD MS (ER physician) @jeremyfaust]

“What the eye doesn't see and the mind doesn't know, doesn't exist."
-DH Lawrence, Lady Chatterley's Lover
Remember that as we go through:
A PRIMER explaining why it makes sense that some people think it’s time to re-open the economy...and why they are fatally incorrect.
Thread!

[Karen Wingartz Small, MD @SmallWingartz]

Test. Track. Treat.

[Craig Spencer MD MPH @Craig_A_Spencer]

Maybe we’re framing it wrong?

By touting ‘opening up America again’, it makes it sound like America is closed.

We’re not closed.

We’re literally all in hiding. From a virus. That will kill many of us. If it finds us.

In a shop. Or on a beach.

In NYC. Or Oklahoma.

🥔,🥔.

[Karen Wingartz Small, MD @SmallWingartz]

If we want to save lives, we need to know where the virus is!

[Jeremy Faust MD MS (ER physician) @jeremyfaust]

Everyone: so how was your last shift?

Me: TEST. EVERYBODY.

Er’yone: Even the the guy with musculoskeletal pain?

Me: TEST. EVERYSINGLEBODY.

[Karen Wingartz Small, MD @SmallWingartz]

What an important life lesson. We may learn something relatively quickly and feel competent. However, it is only more experience that makes us realize the true implications. #NeverTooSmall

[Jeremy Faust MD MS (ER physician) @jeremyfaust]

@intubatesedate @ClydeHaberman @maggieNYT @LelandVittert @JonnyKimUSA @peterbakernyt @davidenrich @wolfblitzer @maddow @ScottWapnerCNBC @CarlosdelRio7

[Karen Wingartz Small, MD @SmallWingartz]

@AnandDoobay @MSHospital Thank you for the dedication to our sickest patients. Thank you for inspiring healthcare workers by celebrating life. #NeverTooSmall

[Karen Wingartz Small, MD @SmallWingartz]

Humanity First USA (@HFUSA) Tweeted:
“May your choices reflect your HOPES, not your fears.. “ - Nelson Mandela #FridayMotivation #HopeFromHome #AllInThisTogether #hopeiscontagious #StayHomeSaveLives 🙏🏼🇺🇸🌎 https://t.co/hgBHL5yXWv

[Humanity First USA @HFUSA]

“May your choices reflect your HOPES, not your fears.. “ - Nelson Mandela #FridayMotivation #HopeFromHome #AllInThisTogether #hopeiscontagious #StayHomeSaveLives 🙏🏼🇺🇸🌎