
Mom & wife & endocrinologist at KCMH @ChulalongkornUš©š»āš»Adrenal researchš©š»āāļø Former postdoctoral research fellow in CV endocrinology at BWH, HMS.
- Tweets578
- Following348
- Followers284
- Likes1.5K

ALT A young man with short brown hair smiles at the camera while holding a smartphone displaying a campaign pledge poster reading, āIām Campaigning for Safer Adrenal Crisis Careā. He is wearing a light grey hoodie and standing indoors. The phone screen features red and blue medical symbols with an arrow between them. The top-right corner features the white Addisonās Disease Self-Help Group logo, with the word āSUPPORTINGā repeated twice in a circular arrangement around it.

ALT A woman with long, straight, light brown hair smiles at the camera while holding a printed campaign pledge poster. She is wearing a blue floral-patterned top and a heart-shaped pendant necklace. The poster reads, āIām Campaigning for Safer Adrenal Crisis Careā and features red and blue medical symbols with an arrow between them. In the top-right corner is the white Addisonās Disease Self-Help Group logo, with the word āSUPPORTINGā repeated twice in a circular arrangement around it.

ALT A woman sits between two dogs, smiling at the camera while holding a campaign pledge poster. A black Labrador-type dog sits beside her on the left, and a brown Labrador-type dog sits on her right. She is wearing a dark top with white trim. The poster reads, āIām Campaigning for Safer Adrenal Crisis Careā and features red and blue medical symbols with an arrow between them. The photograph is framed by teal-coloured bands at the top and bottom, with the white Addisonās Disease Self-Help Group logo in the top-right corner, featuring the word āSUPPORTINGā repeated twice in a circular arrangement around it.

ALT A man smiles at the camera while holding a large campaign pledge poster with a teal border. The poster reads, āIām Campaigning for Safer Adrenal Crisis Careā, with a red āPatient Safety Riskā heading above and red and blue medical symbols with an arrow between them. He is wearing a light-coloured zip-up jacket over a pale shirt. He is standing indoors in a spacious room with exposed wooden roof beams, brickwork and skylights. In the top-right corner is the white Addisonās Disease Self-Help Group logo, with the word āSUPPORTINGā repeated twice in a circular arrangement around it.

ALT Graphic from the Addisonās Disease Self-Help Group (ADSHG) with the headline āCampaigning for Safer Adrenal Crisis Careā in bold red text. Above this is a red button labelled āPatient Safety Risk.ā Supporting text explains that an adrenal crisis is a life-threatening medical emergency requiring a time-critical injection of hydrocortisone. A large grey panel contains a red warning heading: āOther life-threatening conditions have auto-injectors or pre-filled syringes. Adrenal crisis doesnāt.ā Additional text explains that the hydrocortisone injection process is complex and involves multiple steps, leaving patients struggling to self-inject life-saving treatment. It also states that patientsā lives are at risk and hospital admissions are increased because of delayed treatment. Below the text is a red circular illustration showing a syringe, vial and ampoule, with warning symbols. The purple footer contains the call to action āHelp us campaign for changeā followed by a white arrow.

ALT Infographic with an orange gradient background featuring a sun logo from the Addisonās Disease Self-Help Group. The graphic provides hot weather advice for people with Addisonās disease or adrenal insufficiency, including: stay well hydrated (with water icon), keep your salt levels up (salt shaker icon), ensure your fludrocortisone dose is adequate, beware of light headedness and listen to your body (pill icon), keep alert information, such as steroid cards and medical jewellery, with you at all times (exclamation icon), check if any of your medication needs to be kept at a certain temperature and how they should be stored (thermometer and sun icon), and stay cool, slow down, and keep out of the sun (sunglasses emoji). Website www.addisonsdisease.org.uk is shown at the bottom.

ALT Previous manifestations of ASCVD, especially myocardial infarction & an elevated coronary plaque burden on cardiac CT, indicate a higher risk for ASCVD events. The risk depends not only on very high LDL cholesterol concentrations or exposure to elevated LDL cholesterol during lifetime, but also on the presence or risk biomarkers like male sex, high lipoprotein(a), low HDL cholesterol, high BMI & blood pressure, family history of early ASCVD, smoking & comorbidities like diabetes & chronic kidney disease. Specific familial hypercholesterolaemia risk equations, such as SAFEHEART-RE & the familial hypercholesterolaemia risk score, can integrate this risk. ASCVD risk might also be modulated by the effect of genes unrelated to lipids, as aggregated in a polygenic risk score. LDL cholesterol should always be reduced in patients with familial hypercholesterolaemia. Severe familial hypercholesterolaemia is a clear indication for more intensive LDL cholesterol lowering with PCSK9 inhibitors.




























