John W. Downs MD MPH

Internist, #OccEnvMed physician, and medical toxicologist ☠️. Army doc. No exposure➡️No effect. Opinions my own.

[John W. Downs MD MPH @downsjw2000]

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

[John W. Downs MD MPH @downsjw2000]

@ThommyTox Agree. People jumped on this train 🚂 way too hard before thinking about it.

[John W. Downs MD MPH @downsjw2000]

@SteveCurryMD TCE I think

[John W. Downs MD MPH @downsjw2000]

@SteveCurryMD @ToxAndHound Looks like Erythroid leukemia is a type of AML so I'd say D. benzene. Other relationships A - "oat cell" lung CA ; B & C - bladder CA; E - hepatic angiosarcoma

[John W. Downs MD MPH @downsjw2000]

@EMPoisonPharmD @JoeKennedyEM Yeah, I saw this in a store over the weekend.

[John W. Downs MD MPH @downsjw2000]

Caffeine related "Charged Lemonade" death in someone with a congenital Long QT syndrome? https://t.co/ZD8a0Isbor

[Nick Mark MD @nickmmark]

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/

[John W. Downs MD MPH @downsjw2000]

@rushtonation Happy to do so, Will, if you think your staff would have interest. Shoot me an email and we can set up a time.

[John W. Downs MD MPH @downsjw2000]

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.

[John W. Downs MD MPH @downsjw2000]

@EMPoisonPharmD @JoeKennedyEM @JoeKennedyEM , I felt same about cause—>effect but that’ll be up to a jury to decide I suppose. More astounded by that much caffeine in the product, although for 30 oz. I saw those last week and suspected caffeine from “charged” but didn’t think that much.

[Josh Hartzell, MD, MS-HPEd @joshuadhartzell]

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

[Steve Curry @SteveCurryMD]

MedTox Fellows. Remember hexavalent chromium salts as cause of nasal septal perforations for board exams.

[John W. Downs MD MPH @downsjw2000]

Thank you @IronBirds for helping to restore my spirit after a long day of work. 🍿 🌭 ⚾️

[John W. Downs MD MPH @downsjw2000]

@HubDadTox @nephrotox @MDPoisonCtr Congratulations 🎉, Eric! Always great to hear you on rounds.

[John W. Downs MD MPH @downsjw2000]

@SteveCurryMD I was initially going to say the herbicide 2,4-D, but I think that’s actually Dicamba.

[John W. Downs MD MPH @downsjw2000]

@nph_pharmD OMG 😲

[John W. Downs MD MPH @downsjw2000]

@SteveCurryMD Thank you for posting these blog posts from Schachtman Law. I've learned quite a bit about intersection of tox and epi in the court room from reading them.

[John W. Downs MD MPH @downsjw2000]

@mianhi63 Congratulations! Triple boarded!

[John W. Downs MD MPH @downsjw2000]

@SteveCurryMD Don’t know if it’s still ongoing but @rushtonation had a big problem in Alabama for a bit. https://t.co/hWKLbM225i

[Steve Curry @SteveCurryMD]

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 (https://t.co/FIK3XUicUh), and many claims such as: https://t.co/DMn69S3Zpo

[Nick Husak @nph_pharmD]

What if the robot knows this is a bad CCB overdose presenting as a sepsis mimic, and insulin truly is the answer 😮