Medicastra

#Rheumatologist, see me on the blue side

[Medicastra @Medicastra]

@DoctorChrisVT Have you come across this in Nejm yet......

Regulatory Policy to Address Ultraprocessed Foods | New England Journal of Medicine https://t.co/3tsHJe8sya

[John Reynolds @Dr_JohnR]

We have a funded PhD opportunity to study patient preferences in the treatment of #lupus #nephritis using mixed methods. @InflamAge_UoB @DrMarieFalahee
https://t.co/wEBzFnsFM6

[Medicastra @Medicastra]

@OGdukeneurosurg Some diseases have The Hulk like properties. Mostly cool, easy going, minding their own business living around you, and then a trigger pushes (or allows them) to go over the edge and all hell breaks loose.

[Medicastra @Medicastra]

@OGdukeneurosurg What percentage body fat does he have?

[Medicastra @Medicastra]

@IhabFathiSulima I think very broad differential (several infectious causes possible) and I would want to have looked and ruled out possibilities before committing to treatment. Past hx also significant.

[Alberto Giraldo @alb_giraldo]

The addition of urine #alkalization (3.5g bid citrate mixture) to #urate-lowering therapy with #febuxostat is associated with lower albuminuria, fewer flares, and improved serum lipid profile in male patients with #gout.

*Wang C, Guo K, Dalbeth N, et al. Impact of adding urine alkalization therapy to xanthine oxidase inhibitor in gout management: a prospective cohort study. Rheumatology (Oxford). 2025.
🔗https://t.co/PCvuBBWcTK

[Medicastra @Medicastra]

@hemo_shk @IhabFathiSulima Agree with dermatomyositis, not all patients will have elevated creatine kinase or inflammation markers. Do extended myositis panel. Do whole body (if you can) myositis MRI to look muscle oedema (tissue target). Is appropriate screening done cervical smear, breast exam, PSA, FIT.

[Medicastra @Medicastra]

@OGdukeneurosurg It does look like rheumatoid arthritis hand. I would still think though about a Jaccouds arthropathy as have seen someone with reponable ulnar drift labelled as RA, ultimately SLE.

[Medicastra @Medicastra]

@IhabFathiSulima Agree, erythema nodosum. Although multiple causes, in my field would look for swollen ankles and shortness of breath
ACE may (or may not) be helpful. Do CXR to look for hilar LN (even if no reported SOB).

[Medicastra @Medicastra]

@OGdukeneurosurg Larger gloves.

[Medicastra @Medicastra]

@Dr_Aravind_P_MD Polyarteritis nodosa related to hepatitis B. Manage hep B with interferon treatment and steroids. Look for other causes.

[Medicastra @Medicastra]

@RichardPAConway @RheumNow Have seen a couple of OJ and EJ with no clear features of DM. Watching and waiting (how long? ... have done the obvious). They belong to the group also with rare MDA5 (sine everything significant). With MDA5, you do get the full on ones too which means you are always on edge.

[Medicastra @Medicastra]

@IhabFathiSulima I don't think it's the answer in this case but drugs can do this. Some of the newer immunotherapies but I would also think of #hydroxychloroquine. We usually think of pigment in the hard palate but can be in gums.

[Medicastra @Medicastra]

@nicmal9 @TheSpineRace Brave bunch of people.

[Alberto Giraldo @alb_giraldo]

It has been shown that the risk of negative maternal and foetal outcomes due to uncontrolled disease in women with #autoimmune #rheumatic diseases (AIRDs) far outweighs any small risk with the use of #hydroxychloroquine (HCQ) during #pregnancy. Therefore, the counselling should emphasize the safety of HCQ at doses used in AIRDs, i.e. up to 400 mg/day. The available literature underscoring the fact that there are no birth defects ascribable to HCQ, and underpins the recommendations of the major #rheumatology societies regarding the use of HCQ in pre-conceptional and #pregnant women with AIRDs.

📸 Hydroxychloroquine in pregnancy—evidence guiding the balance of recommendations.

*From: Goyal M, Ravindran V. Hydroxychloroquine use in pre-conceptional and pregnant women with autoimmune rheumatic diseases: Evidence-based counselling. Rheumatology (Oxford). Published online July 1, 2024.
🔗https://t.co/8jc8HE1K04

[Samuel Hume @DrSamuelBHume]

Biggest medical discoveries of the week (🧵)

1/8

A twice-yearly prophylactic injection - Lenacapavir - is >95% effective to prevent HIV (in men - it's already proven in women!)

It's even more effective than daily pills (F/TDF), due to better adherence

https://t.co/HDEy4HO3pl

[Medicastra @Medicastra]

@simplify_drugs I think of them as EClAiRs ... Erythro, Clarithro....

[Medicastra @Medicastra]

I would like to sign post you to relevant info but sorry, I am not sure where to point you. But there is a #juniordoctorstrike, it make affect your healthcare decisions but if you are sick, please seek health care.

[Medicastra @Medicastra]

One of the most significant #juniordoctorstrikes of our generation already started and a national? broadcasting service deigns to have it as number 9 on the headline story list. Top reporting!

[Medicastra @Medicastra]

If you are looking after the #galaxy, don't even bother to look. Too busy.