iiinova — where your digital self keeps evolving

Tatiana Prowell, MD @tmprowell.bsky.social · 08/01/2026

"Ah when to the heart of man Was it ever less than a treason To go with the drift of things… And bow and accept the end Of a love or a season." Robert Frost, Reluctance #HistoMap #History #poetry

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Tatiana Prowell, MD @tmprowell.bsky.social · 29/11/2025

#MedSky can we pass $100K by 9am? The person next to me on my plane just said no. I say doctors wake up early & LFG. 💪 Let’s feed some folks! #HCWvsHunger cc @shematologist.medsky.social @hcwvshunger.bsky.social

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Tatiana Prowell, MD @tmprowell.bsky.social · 18/07/2025

#MedSky #IDSky #OncSky NEW RPCT: 5, 10, or 15d of Paxlovid in 156 immunocompromised (IC) outpatients w/ #COVID19. No diff in sustained viral suppression d15-44. 🔑 takeaways: Rebound isn’t rare (1 in 4 of severely IC), & enrichment/endpoint selection matter. www.sciencedirect.com/science/arti...

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Tatiana Prowell, MD @tmprowell.bsky.social · 11/07/2025

#MedSky #OncSky #IDSky Prosp cohorts (China, N=74K): At 8-10 yrs, EBV VCA-IgA was assoc w/: Overall cancer risk ⬆️ 5x Lung cancer 1.8x Liver cancer 1.7x Nasopharyngeal cancer 26x Lymphoma 3.2x Dose-response +. 🔑 We need ways to prevent/treat mono. #DrugDevelopment www.nature.com/articles/s41...

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Tatiana Prowell, MD @tmprowell.bsky.social · 11/07/2025

#MedSky #IDSky 📢 Prospective cohort study (CO-FLOW) of adults hospitalized for #COVID19 finds only 1 in 8 fully recovered at 3m, & only 1 in 4 at 3y. More than half had ⬇️ memory & concentration at 3y. This is #LongCovid. HUGE unmet #DrugDevelopment need. www.thelancet.com/action/showP...

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Tatiana Prowell, MD @tmprowell.bsky.social · 03/07/2025

#MedSky #LongCovid NEW study of outpatients w/ #COVID19 + self-reported #BrainFog after infection vs healthy controls finds marked hypometabolism on PET & brain wave changes on EEG corresponding to areas responsible for attention, memory, language, & decision-making. www.nature.com/articles/s41...

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Tatiana Prowell, MD @tmprowell.bsky.social · 02/07/2025

📣 Calling future oncologists with at least 1y of #oncology training! Apply by 7/9/25 to attend the FDA- @ascocancer.bsky.social Fellows’ Day Workshop: secure-web.cisco.com/1VqNN4qO1FuT... 👉 9/25/25: in person (ASCO HQ, in DC area) or 👉 1/29/26: virtual See you there! #MedSky #OncSky #MedEd

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Tatiana Prowell, MD @tmprowell.bsky.social · 30/05/2025

The @ascocancer.bsky.social Ed Book is the highest-quality, peer-reviewed, FREE #oncology #MedEd ever. Whether or not you’re at #ASCO25, don’t miss this resource, #OncSky #MedSky, #MedStudentSky! Drop a 📌 in the comments to bookmark the link for later. ascopubs.org/toc/edbk/cur... #OncoAlert

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Tatiana Prowell, MD @tmprowell.bsky.social · 04/05/2025

#MedSky Invasive cardiopulm exercise testing (iCPET) at Brigham & Women’s finds people w/ #MECFS & #longCovid have symptomatic ⬇️ aerobic capacity at peak exercise due to preload insufficiency & impaired systemic O2 extraction, latter c/w peripheral L➡️R shunt &/or limb skel muscle dysfunction. /1

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Tatiana Prowell, MD @tmprowell.bsky.social · 11/03/2025

#MedSky #IDSky The # of Americans with new disability has increased sharply in the #pandemic. The # who report a cognitive disability specifically has grown by 43% since 2019. #COVID19 #LongCovid www.nytimes.com/interactive/...

Graph showing change in number of Americans reporting disability over the last decade, with a sharp increase beginning with the COVID19 pandemic

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Tatiana Prowell, MD @tmprowell.bsky.social · 10/03/2025

#MedSky #MedEd #IDSky 📢The 2024 @health.nationalacademies.org Long COVID Definition: What Clinicians Need to Know. If you provide patient care, in any specialty, this 3 pg paper is must read. You are seeing people w/ #longCovid, whether you realize it yet or not. link.springer.com/content/pdf/...

Diagram demonstrating that long COVID symptoms many manifest in any organ system

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Tatiana Prowell, MD @tmprowell.bsky.social · 08/03/2025

Happy #InternationalWomensDay! The work does not stop until all women are thriving. 🤜🏻🤛🏾 🏳️‍⚧️ #BlackWomenInMedicine #LatinasInMedicine #LGBTQ #MedSky

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Tatiana Prowell, MD @tmprowell.bsky.social · 27/02/2025

Follow @helenbranswell.bsky.social for the most current & reliable reporting about everything related to #influenza. She is the queen. #MedSky

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Tatiana Prowell, MD @tmprowell.bsky.social · 25/02/2025

#MedSky #IDSky A randomized, double-blind, placebo-cont trial (N=50) of plasma exchange (2x/wk x 3w) vs sham (saline) in people with mod-severe #LongCovid found no benefit in any efficacy endpoint. Grateful for RCTs & for quality journals publishing them even if neg. www.nature.com/articles/s41...

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Tatiana Prowell, MD @tmprowell.bsky.social · 14/02/2025

#MedSky #PublicHealth Clinicians, YOU are the most trusted source of info on #vaccines for your patients. Regardless of your specialty, take a moment to check if they are up to date on immunizations & inform them that #VaccinesWork.

Graph from KFF showing that health care providers are the most trusted sources of info about vaccines

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Tatiana Prowell, MD @tmprowell.bsky.social · 09/02/2025

#MedSky #IDSky Based on 🇺🇸 wastewater monitoring, #COVID19, #flu A, & #RSV (which cause similar symptoms) & #norovirus (which causes vomiting & diarrhea) are 🚀 nationwide. Other infections are low. There are antiviral meds to treat Covid & flu, so get tested/seek care if sick! wastewaterscan.org

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Tatiana Prowell, MD @tmprowell.bsky.social · 04/02/2025

Why should #MedSky care about literacy? Poor literacy makes our patients less able to locate, understand, & judge the reliability of health information, less likely to take their meds as intended, less likely to participate in #clinicaltrials…& much, MUCH more. /2

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Tatiana Prowell, MD @tmprowell.bsky.social · 04/02/2025

#MedSky #PublicHealth #SciComm IMPORTANT I’ve been thinking a lot today about the crisis of 🇺🇸 illiteracy. More than half of US adults read below 6th grade level, & 1 in 5 can’t read at all. The harms of illiteracy to us ALL are astounding (see 📸). If you can read this, you can help fix this. /1

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Tatiana Prowell, MD @tmprowell.bsky.social · 03/02/2025

📢 Listen: scrolling is a distraction from taking action. Pick some concrete way to help large or small every day, & get to it. I asked our public school counselor Fri what she needs in our school’s free food pantry & just bought it. Be a helper. #MedSky #HCWvsHunger #tariffs

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Tatiana Prowell, MD @tmprowell.bsky.social · 29/01/2025

#MedSky #SurgSky During my surgery rotation in med school, my favorite surgeon taught me to suture, saying “Slow is smooth, & smooth is fast.” In Osler Residency, our motto was “Aequanimitas.” Just two examples of how #MedEd training is excellent prep for your life. 💪

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Tatiana Prowell, MD @tmprowell.bsky.social · 28/01/2025

#MedSky You can contact your elected officials in Congress even if you don’t know who they are. Call the Congressional switchboard (📸 below), & they will connect to the right Rep/Senators based on your address. You can also find them online here: www.congress.gov/members/find...

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Tatiana Prowell, MD @tmprowell.bsky.social · 28/01/2025

#MedSky Looks like EMA changed their handle, so I just deleted my post & reposted with their new handle: @ema.europa.eu.

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Tatiana Prowell, MD @tmprowell.bsky.social · 28/01/2025

All 435 seats in the 🇺🇸 House of Representatives & 33 🇺🇸 Senate seats (📸 below) are up for re-election in the midterms on Nov 3, 2026. Go to the non-partisan vote.org to register to vote or confirm you are registered & sign up for election reminders. Those <18 can pledge to register to vote at 18.

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Tatiana Prowell, MD @tmprowell.bsky.social · 21/01/2025

#MedSky #IDSky ACTIV6 (N=3K, metformin vs placebo x 14d) preprint is out. Metformin did not shorten time to symptom resolution in mild-mod acute #COVID19. Hypoglycemic events equal across arms (n=5), but 7 vs 3 SAEs. Followup continues for 180d outcomes (#longCovid). www.medrxiv.org/content/10.1...

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Tatiana Prowell, MD @tmprowell.bsky.social · 21/01/2025

#MedSky #IDSky #MedEd NEW Retrospective cohort study (N=225K, kids to 21y >3/4 not vaccinated) from NIH RECOVER characterizes diffs in #longCOVID symptoms by race after severe & non-severe #COVID19 illness. #PedSky, may help direct your ROS (eg, #POTS in Asian pts). www.nature.com/articles/s41...

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Tatiana Prowell, MD @tmprowell.bsky.social · 21/01/2025

#MedSky #NeuroSky #IDSky A syst review of 31 #LongCovid studies finds exec dysfunction (nonverbal reasoning, language, & recall deficits) are common even after “mild” #COVID19 & correlated w/ changes in frontal & cerebellar regions of brain. Many symptoms mimic #ADHD. www.cell.com/action/showP...

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Tatiana Prowell, MD @tmprowell.bsky.social · 19/01/2025

#MedSky #IDSky #Norovirus infections, which cause severe vomiting/diarrhea, are continuing to 🚀. See 🧵 for what you need to know. A key point is that this virus is so contagious & you MUST #WashYourHands w/ soap & water. Hand sanitizer is not effective vs norovirus. www.science.org/content/arti...

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Tatiana Prowell, MD @tmprowell.bsky.social · 15/01/2025

🧵 #MedSky #OncSky #IDSky #CardioSky @FTC has released a report finding that pharmacy benefit managers (PBMs) charge markups up to thousands of percent for #cancer, #HIV, & other life-saving generic drugs, netting billions of 💵 in profit while patients pay more. www.ftc.gov/news-events/...

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Tatiana Prowell, MD @tmprowell.bsky.social · 12/01/2025

#MedSky #PedsSky #NeuroSky #PsychSky #MedEd First International Meeting on #LongCovid in Children recordings are now available here (no paywall) via @surf4children & colleagues: open.substack.com/pub/danilobu...

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Tatiana Prowell, MD @tmprowell.bsky.social · 08/01/2025

NEW #MedSky #PsychSky #NeuroSky A two-sample Mendelian randomization analysis finds no causal relationship between #depression & myalgic encephalomyelitis/chronic fatigue syndrome (#MECFS). Important: people w ME/CFS are NOT “just depressed.” #MedEd #LongCovid www.nature.com/articles/s41...

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Tatiana Prowell, MD @tmprowell.bsky.social · 08/01/2025

NEW #MedSky #OncSky Cohort study (N=4.5K) in current smokers w/ cancer (any tumor type or stage) finds free #smoking cessation program (6-8 counseling appts & 10-12w of nicotine replacement &/or other meds) improves survival, with best results if done within 6m of #cancer diagnosis. ja.ma/4iTDsxr

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Tatiana Prowell, MD @tmprowell.bsky.social · 05/01/2025

#MedSky #IDSky After many GI infections, including #norovirus, the GI tract makes less lactase, the enzyme responsible for breaking down lactose in dairy products. It’s pretty common to become newly lactose-intolerant for weeks to months w/dairy causing cramps, bloating, gas, or diarrhea. /13

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Tatiana Prowell, MD @tmprowell.bsky.social · 05/01/2025

#MedSky #IDSky #OncSky While most households will recover after a couple incredibly miserable days for each person, babies, people over 65, the #immunocompromised, & any at increased risk of dehydration can become severely ill. Know the signs of dehydration & seek medical care. /11

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Tatiana Prowell, MD @tmprowell.bsky.social · 05/01/2025

#MedSky #IDSky Important: the diluted bleach solution must stay on at least 5 mins! Don’t have or can’t use bleach? Check if another product works against #norovirus by finding EPA reg # on label & then scrolling to table at very bottom at this link to check: www.epa.gov/pesticide-re... /7

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Tatiana Prowell, MD @tmprowell.bsky.social · 05/01/2025

#MedSky #IDSky Second, use bleach-based cleaners for #norovirus if poss. CDC recommends cleaning using diluted bleach. Get a new bottle of bleach (first opened < a month ago for best effect) & add 1/3 - 1 1/2 cups of bleach to a gallon of water. I go at stronger end, but must ventilate area well. /6

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Tatiana Prowell, MD @tmprowell.bsky.social · 05/01/2025

#MedSky #IDSky Given how contagious #norovirus is & how it spreads, it is like a brushfire in close quarters and/or where common items are handled by many. Cruise ships are famous for outbreaks, but also daycares/schools, dorms, dining hall/salad bars, nursing homes, barracks, gyms, jails, etc. /3

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Tatiana Prowell, MD @tmprowell.bsky.social · 05/01/2025

#MedSky #IDSky #Norovirus spreads when as few as 10 viral particles get in the mouth. Spread is usually via direct contact (eg, kissing), contaminated food/water, or touching contaminated surfaces (countertop, toy, soiled clothes) then mouth (eg, toddler toy in mouth, eating by hand, nailbiting). /2

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Tatiana Prowell, MD @tmprowell.bsky.social · 05/01/2025

#MedSky #IDSky #PublicHealth There is a widespread outbreak of #norovirus, a GI virus that causes projectile vomiting & profuse diarrhea usually lasting 24-48 hrs. Wastewater levels nationwide in 🇺🇸 are high. It’s miserable & incredibly contagious. So many friends are texting SOS, so here’s a 🧵. /1

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Tatiana Prowell, MD @tmprowell.bsky.social · 01/01/2025

#MedSky #IDSky #PublicHealth The ⬇️ in respiratory viral infections w/ universal masking included #COVID19, #influenza, & #RSV: ja.ma/3Z5fdn7. We need universal masking in hospitals, especially now when #SARSCoV2, #flu, & #RSV levels are high nationwide in 🇺🇸 based on wastewater testing. /2

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Tatiana Prowell, MD @tmprowell.bsky.social · 01/01/2025

#MedSky #IDSky #PublicHealth NEW Analysis of 641K hospital admissions (10 hospitals in 3.5y) finds ending universal masking & #COVID19 testing was assoc w/ a 25% ⬆️ in hospital-onset resp viral infections (w/ longer stay & ⬆️ mortality) & resumption of universal masking w a 33% ⬇️. #WearAMask /1

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Tatiana Prowell, MD @tmprowell.bsky.social · 30/12/2024

#MedSky #NeuroSky #Psych NEW Depression (D) symptoms may come & go, but a study has found the frontostriatal salience network, which tells us what is worth paying attention to, is 2x expanded in brains of people w/ D regardless of symptoms & even before symptom onset. www.nature.com/articles/s41...

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Tatiana Prowell, MD @tmprowell.bsky.social · 30/12/2024

Yes, #melanoma can also rarely occur in the eye, which is called ocular melanoma. Here’s some info on risk factors, symptoms, & pics (note: some melanomas in the eye are readily visible, & others can be seen only via a dilated eye exam). #melsm #MedSky #OncSky #MedEd

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Tatiana Prowell, MD @tmprowell.bsky.social · 30/12/2024

#MedSky #LongCovid #NeuroSky #PsychSky NEW & IMPORTANT Evidence that mitochondrial dysfunction is a major consequence of #COVID19 infection Impaired mito➡️ accumulation of reactive oxygen species➡️ endothelial dysfunction➡️ toxic molecules cross blood-brain barrier www.nature.com/articles/s41...

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Tatiana Prowell, MD @tmprowell.bsky.social · 29/12/2024

The outcomes for people with #melanoma have improved dramatically in the last 2 decades. Still you’ll have the best odds of cure if the cancer is caught before it has spread to lymph nodes or organs, so if you notice something suspicious, get it checked out. /4 #melsm #MedEd #MedSky #OncSky

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Tatiana Prowell, MD @tmprowell.bsky.social · 29/12/2024

People with dark skin can also get melanoma (though they are at much lower risk than people with fair skin). And #melanoma can appear in unusual places including some you might not expect like your nails or even areas that get little or no sun exposure. /3 #melsm #MedSky #MedEd #OncSky

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Tatiana Prowell, MD @tmprowell.bsky.social · 29/12/2024

It’s important to know who’s at ⬆️ risk for #melanoma (see 📸 ). UV exposure (☀️ or tanning bed) is the major risk. Having 5 sunburns doubles your lifetime risk of melanoma. Age matters: ONE blistering sunburn as a kid/teen doubles lifetime risk! 🔑 AVOID BURNS (& TANNING BEDS)! /2 #MedSky #melsm

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Tatiana Prowell, MD @tmprowell.bsky.social · 29/12/2024

President #JimmyCarter died today at age 100, having lived w/ #melanoma that had spread to his brain & liver for >9y. I grew up in GA admiring him, so as an oncologist, I’d like to honor his life by teaching a bit. #melsm #MedSky #OncSky #MedEd First, the ⚠️ signs (ABCDE 👇) & some examples: /1

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Tatiana Prowell, MD @tmprowell.bsky.social · 29/12/2024

#MedSky #OncSky #MedEd I use this slide every year when teaching the #oncology fellows about #cancer #drugdevelopment: “The dose makes the poison.”

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Tatiana Prowell, MD @tmprowell.bsky.social · 28/12/2024

#MedSky #CardioSky NEW Study comparing people hospitalized for #COVID19, cardiovascular disease (CVD) controls, & healthy controls finds #Covid group has significant autonomic dysfunction (⬇️ vagal tone & sympathetic dominance), similar to people w/ severe CVD. www.nature.com/articles/s41...

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Tatiana Prowell, MD @tmprowell.bsky.social · 28/12/2024

⚠️ #MedSky public service announcement: if you/your family are among the ~60% of eligible Americans who haven’t yet had the 2024-25 flu shot, it’s time. Influenza A is 🚀 nationwide in wastewater (via @BiobotAnalytics). CDC recommends #FluShot for age 6 mos & up.

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