Mark Lawrence Lagac

32. Internal Medicine. Rheumatologist-in-Training.

[Mark Lawrence Lagac @marklagacmd]

Siguro, if you ask your doctor friends for consult and they didn’t charge you but advised you & gave you prescription, the least you can do is update them how you are doing -if you got better or not, because we do care if our patients get better or not, esp if they’re our friends

[Durga Prasanna Misra @DurgaPrasannaM1]

The #EULAR recommendations for the management of Polymyalgia Rheumatica and Large Vessel Vasculitis were presented today at #EULAR2026 at London by the task force lead Dr Chetan Mukhtyar. It was a privilege to represent India on this international task force! I hope these recommendations lead to the better management of patients with PMT, GCA and Takayasu Arteritis. Watch out for the publication of these recommendations in the future!

[Laurent ARNAUD @Lupusreference]

✅ This #EULAR2026 session about the assessment of disease activity in #lupus trials was particularly interesting as the field is moving forward fast:
- LAMDA for MSK
- TRM-SLE for SLE/LN trials
- DORIS+ for the deep dive into deep #remission
Seeyou tomorrow for more about lupus!

[Dr. John Cush @RheumNow]

Progress of biologics/targeted therapy in SLE

We are in a transformative era for SLE, for clinicians and patients. Four targeted therapies are now licensed: belimumab (nephritis and non‑renal), voclosporin and obinutuzumab (nephritis), and anifrolumab (non‑renal). Many agents with different mechanisms are in late‑phase trials. We'll preview data at EULAR 2026 in London.

https://t.co/gV22TmHnVf

[Laurent ARNAUD @Lupusreference]

✅ and this is the start of the #SLICC group meeting at #EULAR2026. Moving forward ⏩ the care of #lupus patients 👍 We have an incredible panel of international #SLE experts in the room today 🌍🌎🌏

[Chel Diokno @ChelDiokno]

Pumasa sa Kamara ang Pro-Dynasty Bill ‼️

Ngayong araw, bumoto tayo ng NO sa third and final reading ng House Bill No. 8389.

Sa ilalim ng panukala, pwede pa ring mamuno ang isang pamilya sa iba’t ibang antas ng gobyerno. Hindi nito winawakasan ang political dynasties. Ginagawa lang nitong legal ang dati nang mali.

Panoorin ito para sa buong detalye. Comment below kung naniniwala kang hindi dapat minamana ang kapangyarihan!

[Ritasman Baisya @RitasmanB]

Nail fold capillaroscope teaching at EULAR 2026 @eular_org @EUSTAR_org

[Nico B. Valderrama @nbvneverquits]

Ganito na lang.

I-assume natin na pumasok kahapon ang lahat ng 22 Senators na maaaring pumasok, dahil bayad naman sila ng taumbayan para pumasok.

May quorum? Yes.

Ilan ang kailangang bumoto para makagalaw ang Senado sa isang ordinary motion? 12, dahil iyon ang majority ng 22 Senators present. Ngayon, kung may motion si Senator Sotto na i-declare na bakante ang lahat ng posisyon sa Senado, at 12 Senators ang bumoto pabor, ano ang resulta?

Mababakante ang mga posisyon, kasama ang Senate Presidency. Ganito rin nabakante ang mga posisyon nung huling namuno si Senator Sotto at nag-motion si Senator Villanueva nung May 11, 2026 to declare all Senate leadership positions vacant.

Makakahalal ba sila agad ng Senate President? Hindi, kung walang makakuha ng 13 votes. The Constitution requires the Senate President to be elected by majority vote of all the Members of the Senate.

Pero makakahalal ba sila ng Senate President Pro Tempore? Yes.

Bakit? Dahil ang Constitution mismo ang nagsasabi na each House shall choose such other officers as it may deem necessary. Ang Senate President Pro Tempore ay hindi Senate President. Isa siyang ibang officer na kinikilala ng Rules of the Senate na dapat ihalal ng majority of all members of the Senate.

So ano ang dapat gawin? I-harmonize ang Constitution at ang Rules of the Senate.
Dapat ba ang interpretation ay hahayaang walang mahalal at maparalisa ang Senado? Hindi. A reading that leaves the Senate unable to organize or transact business should be avoided, because the Constitution contemplates a functioning Senate, not a paralyzed chamber.

Hindi hinalal si Senator Gatchalian bilang Senate President Pro Tempore para pumalit kay Senator Legarda personally. Hinalal siya para punan ang posisyong nabakante dahil sa lehitimong motion ni Senator Sotto.
Hindi rin siya nahalal na Senate President by 12 votes.

Ang nangyari ay ito: nabakante ang Senate Presidency; walang nahalal na Senate President dahil walang 13 votes; ngunit may valid election ng Senate President Pro Tempore under the Constitution and the Rules of the Senate. By operation of the Rules of the Senate, the Senate President Pro Tempore acts as Senate President while the office is vacant.
Hindi lamang sinabi ng Avelino v. Cuenco na hindi kasama sa pag-determine ng quorum ang mga Senador na hindi maaaring i-compel na umattend. Sinabi rin ng kaso na makatwiran na bigyang-bisa ang nais ng nakararami, lalo na sa pagpili ng mamumuno sa Senado, dahil ang pagpili ng Senate leadership ay nakadepende sa will of its members.

Higit sa lahat, hindi pinapayagan ng Constitution na paralisado ang kahit isang Kapulungan ng Kongreso. Kailangan pa ba talagang isulat iyon? Kahit ang taumbayan, hindi papayag na hindi magtrabaho ang mga pinapasweldo nila sa gobyerno.

Kahit grade 1 student, pumapasok nang walang bayad dahil alam niyang tungkulin niyang mag-aral. Ang mga senador pa kaya? Sila itong may malaking budget para kumuha ng magagaling na abogado na magpapaliwanag kung ano ang maaari at hindi maaaring gawin sa Senado.

[Dr. John Cush @RheumNow]

Meet the RheumNow #EULAR2026 Reporting Team

Delivering real-time insights from the forefront of rheumatology:

🩺 Dr. Antoni Chan (@synovialjoints)
�� Dr. Mrinalini Dey (@DrMiniDey)
🩺 Dr. Jiha Lee (@JihaRheum)
🩺 Dr. Aurelie Najm (@AurelieRheumo)
🩺 Dr. Janet Pope (@Janetbirdope)
🩺 Dr. Yuz Yusof (@Yuz6Yusof)
🩺 Dr. Nelly Ziade (@Nellziade)
🩺 Dr. Bella Mehta (@bella_mehta)
🩺 Dr. Sheila Reyes (@RHEUMarampa)

RheumNow brings you expert-led coverage from #EULAR2026. The science at #EULAR2026 will move fast.

[Chel Diokno @ChelDiokno]

Wow! Sana all may choices. 😒🙄

Yung ordinaryong Pilipino, walang option. Kinulong agad dahil napagkamalang nanlilimos.

Pero kapag makapangyarihang opisyal na may kasong plunder at graft, may pa-consultation muna?

Dapat patas ang proseso. Walang special treatment, walang VIP lane, walang batas na para lang sa mahihirap.

[marv @mvn_dn]

telling the Asst Ombudsman to his face “Wala kaming pakialam sa mga ganyan…ang tanong namin, kailan may makukulong? Kailan may mananagot?” 😭
Doris Bigornia MOTHER

[Kiko Pangilinan @kikopangilinan]

JOINT STATEMENT ON THE SENATE MINORITY WALKOUT

We strongly condemn what appears to be an attempt to rush a major change in the Senate Rules, especially when several members of the minority still wanted to speak and raise serious questions on the floor.

Bakit kailangang madaliin? Bakit kailangang pigilan ang mga gustong magsalita? Bakit kailangang i-divide ang house kung marami pang senador ang nagtatanong tungkol sa proseso?

Minamadali ba ang rule change na ito dahil gusto nilang maka boto si Senator Bato? At ngayong may mga ulat na may mga majority senators na maaaring arestuhin?

We walked out because what happened on the floor looked less like orderly deliberation. The proposed rule change affects how senators may attend sessions, participate in proceedings and exercise their mandate through remote means, and such a measure should be opened to healthy public debate instead of being rushed by the tyranny of the majority.

We have always welcomed healthy discussions on the floor, but this should mean allowing all members to be heard, not forcing the chamber to move at the speed preferred by the majority.

At the time the motion was taken up, there was no duly constituted Committee on Rules and there was not even an elected Majority Leader who could properly guide a rules amendment through the regular process.

How could there have been any action or discussion before the Committee on Rules when no Committee on Rules has been organized to date?

With due respect, the answer that no Senate rule had been violated does not settle the matter, because the rules cannot be treated as a matter of convenience when the very process for amending them is under serious question.

The timing raises a question that the public deserves to hear debated openly. Kaya pinili naming tumayo at iwan ang majority sa plenary. Kaya kami nagdesisyon to question the quorum and call for adjournment.

If the proposal is truly defensible, then let it pass through the proper route.

We owe it to the people who voted for us to do our mandate. This is why we want more time to discuss this further.

[Math Files @Math_files]

(a + b)² = a² + 2ab + b²

[Laurent ARNAUD @Lupusreference]

✅ SAVE THE DATE for the next international congress on #lupus, which will take place in Florence, Italy, 8-11 May 2027, jointly with #CORA2027 🇮🇹 I have been invited to join as a faculty member so it will be another opportunity to meet altogether for more #SLE discussions 👍

[Just @justinmaniluh]

“Hindi ka tao ni Sara kung ikaw ay Senador — tao ka ng bayan!”

In his homily today, Bishop Bacani who is also one of the framers of the constitution reminded the Senators that public office is a public trust.

And if you are a senator… you cannot say that you will vote against the impeachment despite the clear evidence just because “tao ka ni Sara”.

[Aravind Palraj @Rheumat_Aravind]

ANCA Vasculitis made simple 🔥

🔹 GPA → ENT + lung nodules + c-ANCA(PR3)
🔹 MPA → renal + pulmonary capillaritis + p-ANCA(MPO)
🔹 EGPA → asthma + eosinophilia + neuropathy

One of the highest-yield topics in rheumatology & medicine.

Which pattern do you find hardest to remember?

#Rheumatology #Vasculitis @docakx @IhabFathiSulima #MedTwitter #InternalMedicine #Nephrology

[Cristina Tejera @cristinatejerap]

¿Cuándo elegir semaglutida y cuándo tirzepatida?
La EASO acaba de actualizar su algoritmo con evidencia hasta noviembre 2025 📊 @EASOobesity

Spoiler: depende del objetivo clínico. No es solo pérdida de peso.

🔗 @NatureMedicine

https://t.co/RKkccNGYTq

#ECO2026

[GMA News @gmanews]

PAANO NAKAALIS NG SENADO SI BATO?

Base sa dokumentong nakuha ng GMA News, pasado 2:30 AM ng May 14, 2026 nakaalis ng Senado si Sen. Bato dela Rosa kasama si Sen. Robin Padilla.

Narito ang unang mga detalyeng nakuha ng GMA News.

Bisitahin ang https://t.co/bAMF9JOAN0 para sa iba pang mga balita.

[Jon Viktor Cabuenas @ViktorCabuenas]

Some of the biggest business groups in the Philippines call on senators to fulfill their constitutional mandate “with honor, integrity, and unwavering regard for their oath of office.”

“For the business community, the implications are significant.”

[Karen Davila @iamkarendavila]

Someone has to be made accountable for Bato’s escape.

No less than the DILG Secretary and PNP Chief entered the senate building last night to secure the senators.

The public was assured last night Bato was in the “5th foor, in his room, resting���. Bato’s lawyer showed a video last night of Bato supposedly in the senate.

The senate building should’ve been secured last night - no one in, no one out.

We need answers. How did Bato escape? Who helped him?

[Thea Tan @imtheatan]

🚨 The "Bato" Diversion: A Staged Siege to Shield Sara Duterte

After looking at the sequence of events, I am more inclined to believe this entire spectacle was a "zarzuela" designed to protect Vice President Sara Duterte rather than Sen. Bato dela Rosa.

Using Sen. Bato's ICC paranoia as a shield, the Senate leadership successfully manufactured a crisis to delay the constitutional process.

Here is the chronology of how this diversion was staged:

✳️ The Setup: May 11–12, 2026

• May 11 – The Impeachment Vote: The House of Representatives votes 257–25 to impeach VP Sara Duterte.

• May 11 – The Senate Coup: Minutes before the House vote, the Senate leadership is toppled, and Sen. Alan Peter Cayetano (APC) is installed as Senate President.

• May 11 – The Pursuit: Bato dramatically outruns NBI agents through Senate hallways and staircases, eventually reaching the chamber where APC immediately offers him “protective custody.”

• May 12 – The Legal Wall: The Senate spends the day formalizing a policy to reject any arrest by a foreign court without a local warrant, creating a "Legislative Sanctuary."

• May 12 - The Safe House: Bato officially begins sleeping at the Senate to turn the building into a fortress.

• May 12 – Public Defiance: Bato holds a press conference inside the Senate, appearing defiant and vowing to fight the ICC arrest order, further cementing the building as his permanent “safe house.”

————

✳️ The Escalation: May 13 (The Night of the Siege)

2:25 PM: Bato sings the PMA Hymn twice during a briefing to emotionally appeal to the military and his fellow Cavaliers to stand by him.

5:23 PM – The "Intel" Claim: Following the SC’s refusal to protect him, Bato goes on Facebook Live claiming he received "intelligence" that he will be arrested the moment the Senate adjourns.

He calls on supporters to gather at the Senate gates for a “vigil,” claiming his arrest is imminent.

6:14 PM – The Supreme Court officially announces it has deferred action on Bato’s petition and does not issue a TRO.

6:57 PM – Senate Sergeant-at-Arms Mao Aplasca orders the media and staff to clear the second floor, explicitly claiming: "They are going to arrest somebody."

7:00 PM: Duterte Supporters swarm the Senate gates, shouting at and intimidating vehicles attempting to leave the premises.

7:05 PM – Aplasca declares a total lockdown, creating a physical barrier to replace the legal protection the Supreme Court refused to provide.

7:22 PM – THE TRIGGER: The House formally transmits the Articles of Impeachment — the 257-vote mandate — to the Senate.

7:30 PM: Lockdown begins. The new Sergeant-at-Arms, Mao Aplasca, deploys OSAA personnel in bulletproof vests carrying long firearms.

7:45 PM: Sen. Imee Marcos claims a standby aircraft (RP-C5219) is waiting in Villamor for Bato’s extradition.

7:48 PM – THE MYSTERY SHOTS: Roughly 10 gunshots are heard inside the building, creating the "active shooter" panic needed to justify the lockdown.

8:01 PM – Minutes after the shots, APC launches a Facebook Live, claiming the "Senate is under attack."

8:15 PM – Imee Marcos, Bong Go, Mark Villar, and Jinggoy Estrada launch their own lives, framing the night as a "sovereignty crisis" to bury the impeachment news.

8:45 PM – Cong. "Meow" (Kiko Barzaga) posts on FB that "multiple people died," though no casualties were ever found.

8:55 PM – DILG Secretary Jonvic Remulla arrives calmly without tactical gear to meet with the snacking senators.

9:15 PM – Remulla appears on Bong Go’s live feed to clarify: "I will not arrest Senator Bato."

11:13 PM – President Bongbong Marcos Jr. issues a statement assuring the public that no state security forces (NBI/DILG) were involved in the shooting and confirms he gave no order to arrest Bato.

11:30 PM: Senators are seen in photos casually snacking and laughing inside Senate.

[Continue reading…]

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