Dr. EteroCOVID!

Reumatologia 🩻
Gemelo #1

[Dr. EteroCOVID! @JJReuma]

@JuanPiEscareno @Maistrocampeon Uno que se viste dé trabuco?

[Dr. EteroCOVID! @JJReuma]

@Nightli68397147 @ectorjaime @Claudiashein Por cierto, no confundas servicio social con posgrado, una gran cantidad de posgrados tienen beca sin importar la carrera

[Dr. EteroCOVID! @JJReuma]

@Nightli68397147 @ectorjaime @Claudiashein La residencia médica no es un servicio social, eres estudiante (posgrado) y trabajador, hasta eres considerado servidor público. Además las jornadas llegan a ser de 24H, hasta el año pasado eran de 36H, que otra carrera hace eso?

[Dr. EteroCOVID! @JJReuma]

@ErnestoLenGuti1 @c4jimenez @FiscaliaCDMX Son de la funeraria, no de ellos, son carrozas fúnebres

[Dr. EteroCOVID! @JJReuma]

@enzo_beskow @Abubukaka Por eso está tan saturado los servicios de salud pública!

[Dr. EteroCOVID! @JJReuma]

@BastidasJCR @Fa21519230 Pues tampoco dice si tomaba algo más! Terapias nuevas y avanzadas para el cancer

[Dr. EteroCOVID! @JJReuma]

@BastidasJCR @Fa21519230 No estás leyendo que tomaba fenbendazol!!! Eso es lo curioso de la publicación

[Dr. EteroCOVID! @JJReuma]

@WazuCarden72141 @migangnoguera Los médicos no tienen acceso a fermacia y los que surten medicamentos o son encargados de esas áreas no son médicos. No te confundas, en un hospital no solo hay médicos, hay ingenieros, informáticos, licenciados que bien ellos sí pueden estar en esas áreas y a ellos no insultan

[Shuy® 🇲🇽 @jesus_solis]

¿A quién se le ocurren estas mamadas? Ptm, Méjico no domina al mundo porque no quiere.

[Alerta News 24 @AlertaNews24]

🇺🇸 | Michael Jordan admite que tiene una cuenta de Twitter secreta en donde le gusta pelearse con la gente.

[Dr. EteroCOVID! @JJReuma]

@tatimica19 @EsdeProfugos No pues los papás también son autistas

[Alberto Giraldo @alb_giraldo]

Ordering a #rheumatoid factor (RF) test in a patient with no suspected rheumatoid #arthritis (RA) or other autoimmune disorder is problematic. Although the name "rheumatoid" leads many doctors to associate it with RA, RF testing is not a suitable screening technique for RA in the general population and can be positive in several other chronic conditions (autoimmune and other types, especially infectious), as well as in the normal general population (5% in healthy 50-year olds and 10-25% in healthy 70-year olds). A significant amount of time is wasted in rheumatology clinics due to positive RF results ordered for diseases with which it is not even associated.

[Atsuhiko Sunaga @AthGasu2019koto]

Systematic review of MTX use in RA-ILD.
📝Not associated with ILD development (9 studies) and ILD progression (5 studies)
📝Associated with better survival (1 study) and acute exacerbations (1 study)
🤔Time to use MTX appropriately
https://t.co/OGpLF7X3Cd

[PharmaConnect @Pharma_Connect]

💉 Denosumab:
-Denosumab is a monoclonal antibody that inhibits RANKL, a key protein needed for osteoclast formation → ↓ bone resorption and ↑ bone density.

📌 Clinical Uses:
It can be used for
•Postmenopausal osteoporosis (to reduce fractures)
•Bone loss due to androgen deprivation (men with prostate cancer) or aromatase inhibitors (breast cancer)

•Prevention of skeletal-related events in bone metastases
•Giant cell tumor of bone
•Hypercalcemia of malignancy refractory to bisphosphonates

The dose and frequency as well as the product determine the conditions that can be treated.✨

⚙️ Mechanism of Action:
•Binds RANKL, preventing it from activating RANK on osteoclasts →
🦴 ↓ Osteoclast activity
🦴 ↓ Bone breakdown
🦴 ↑ Bone mineral density

⚠️ Key Safety Points:
•🧪 Check serum calcium, phosphorus, and magnesium before each dose
•🚫 Contraindicated in hypocalcemia — correct before use
•🦷 Risk of osteonecrosis of the jaw (ONJ) — maintain good oral hygiene
•⚡ May cause hypocalcemia, skin infections, or rebound fractures if stopped abruptly

💊 Clinical Tips:
•If stopping denosumab → switch to bisphosphonate (to prevent rebound bone loss & fractures)
•Ensure adequate calcium (≥1000 mg/day) + vitamin D (≥400 IU/day) intake

🧠 Mnemonic: “DENO”

D – Don’t stop suddenly (rebound fractures)
E – Ensure calcium & vitamin D
N – Not for hypocalcemia
O – Osteonecrosis of jaw (rare but serious

[Ravi Kumar @RheumattDoc]

💉 IVIG (Intravenous Immunoglobulin)

🔹 What It Is 🧪

A sterile preparation of pooled IgG antibodies derived from the plasma of thousands of donors.
→ Acts as immune support or immune modulator, depending on indication.

🔹 Mechanism of Action ⚙️

💭 Depends on indication:
•🛡️ Immunodeficiency: Provides passive immunity (antibody replacement).
•🔄 Autoimmune / Inflammatory:
• 🧩 Fc receptor blockade → ↓ phagocytosis of autoantibody-coated cells
• 🎯 Neutralization of pathogenic autoantibodies
• 🔥 Suppression of proinflammatory cytokines
• 🌿 Expansion of regulatory T cells (Tregs)
• 🧊 Inhibition of complement activation

🔹 Common Clinical Uses 🏥

🧬 Immunodeficiency:
•CVID
•X-linked agammaglobulinemia

⚡️ Neurology:
•Guillain–Barré syndrome
•Myasthenia gravis crisis
•Multifocal motor neuropathy
•Autoimmune encephalitis

❤️ Rheumatology:
•Systemic lupus erythematosus (SLE) – esp. refractory cytopenias or neuropsychiatric lupus
•Dermatomyositis / Polymyositis – steroid-sparing or rescue therapy
•Antisynthetase syndrome
•Vasculitis (e.g., ANCA-negative or refractory cases)
•Catastrophic antiphospholipid syndrome (CAPS)
•Systemic sclerosis overlap syndromes

👶 Other:
•Kawasaki disease
•Immune thrombocytopenia (ITP)

🔹 Dosing 💊
•Induction: 1–2 g/kg total (over 2–5 days)
•Maintenance: 400–600 mg/kg every 3–4 weeks (replacement therapy)

🔹 Adverse Effects ⚠️
•😣 Mild: Headache, fever, chills, fatigue
•⚡ Moderate: Aseptic meningitis, thrombosis, hemolysis
•🚨 Severe: Renal failure (esp. sucrose-containing IVIG), anaphylaxis (IgA deficiency)

🔹 Monitoring 🧾
•💧 Baseline renal function
•🧫 Serum IgG levels (for replacement therapy)
•👀 Monitor for thrombosis or hemolysis

#RheumatDocX #MedTwitter #RheumTwitter #rheumatology @IhabFathiSulima @DrAkhilX @CelestinoGutirr @Janetbirdope

[Dr. EteroCOVID! @JJReuma]

@GattoMed @AlertaMundoNews Y que tiene??? No hay justificación!! Son unos malnacidos sus compañeros. No vengas a decir pendejadas

[Dr. EteroCOVID! @JJReuma]

@abbate952 @AlertaNews24 No, pero los choferes de camiones y trailers son super imprudentes

[Dr. EteroCOVID! @JJReuma]

@emandujano1956 @carlos83_rivera @DerechaDiarioMX No le entró a los golpes, como persona educada trato de frenar un pleito, y fue agredido

[Dr. EteroCOVID! @JJReuma]

@Garcimonero @Arturo111913957 Pero quién está sujetando con ambas manos alito a noroña, el cual tiene la mano semiflexionada tanto muñeca como dedos, no es posición de empuje ni de golpe

[Alerta News 24 @AlertaNews24]

🇧🇷 | Delincuentes fueron baleados al intentar robar a dos personas en Sao Paulo, Brasil.