Discover and read the best of Twitter Threads about #rheumatology

Most recents (11)

"Ever get the feeling you've been cheated?" (John Lydon)

The publication of this letter & the nature of its correction raises questions about the reliability of the academic record.

@llantwit @FFLMUK @RCPath @AAPTTweets @mike4path @Richard56 @JJPJ #autopsy

THREAD

1/14
When the letter by Won Sriwijitalai & Viroj Wiwanitkit was published in #JFLM, fact-checking journalists @SureAndShare in Thailand shared their concerns about it on @Twitter & @Facebook.

2/14
@SureAndShare were concerned that they were unable to verify who the 1st author was (or where they worked), or the death of a #forensic #medical professional from #COVID19. They cautioned against sharing the story.

3/14
Read 15 tweets
All right #dermtwitter & #medtwitter, it's time for the...

@MedDermSoc & @DermHospitalist Mini-Symposium on #COVID19 & #dermatology!!

I will be attempting to #livetweet the Zoom meeting!

Join along if you'd like. I will be using the h/t #COVIDDerm!

@RoxanaDaneshjou @dschless
Let's get started!!!!

Your cohosts are super excited to have you join. To give a little background, this meeting was planned in ~1 week, and we have over 500 RSVPs!

@MishaRosenbach now kicking us off with #COVIDDerm! Image
.@DrEstherFreeman is speaking and reminding us all to register our #COVID19 #dermatology cases in the @AADskin #COVID registry!

Reminder to do so here:
aad.org/covidregistry

#COVIDDerm
Read 39 tweets
Patients with autoimmune diseases, such as #lupus and #RheumatoidArthritis, are having trouble filling their prescriptions since Trump touted their medicine as an experimental treatment for #Covid19. /thread news-journalonline.com/news/20200405/…
“The hasty and inappropriate interpretation of the literature by public leaders has potential to do serious harm" write 2 rheumatology experts in the Annals of Internal Medicine. annals.org/aim/fullarticl…
FL pharmacists report "nearly all of the new prescriptions for #hydroxychloroquine are being issued for the prescribing practitioners themselves or family members of the prescribing practitioners." Some drs are prescribing it to healthy people as a #Covid19 preventative.
Read 12 tweets
Hidroxychloroquine (HQ) basics for non-rheum in COVID-19:
- Increases endosomal pH, interferes with the glycosylation of cellular receptors of SARS-CoV2.
- In vitro activity in SARS-CoV and SARS-CoV2.

Proposed dosing (COVID-19): 400 mg bid 1 day➡️200 mg bid 4 days. Longer tx?
Usually very well tolerated, most of adverse effects after months/years of therapy!
Better profile compared to chloroquine.

- Retinopathy. After long time-exposure, risk factors: > 5 mg/kg/day, renal insufficiency, tamoxifen use, obesity...
Not a problem for short term.
- Skin. Pruritus, rash, photosensibility...

- Myopathy. Rare. Usually long term use (1 year-10 years). Neuromyopathy (lisosomal changes, vacuoles in biopsy). Simmetrical weakness+/- sensitive symptoms.
Read 7 tweets
“Around 2012 or 2013, researchers identified evidence that gadolinium retention was connected to illness in patients with normal kidney function.” scholar.google.com/scholar_case?c…
“In September 2017, after the FDA voted to add concerns about gadolinium retention on warning labels, [gadolinium-based contrast agent] manufacturers, including Defendants, issued a new joint warning to patients with normal kidney function.” scholar.google.com/scholar_case?c…
“The warning [RE: #gadolinium retention] also directed physicians to advise patients of these concerns.”

Consent: valued in the United States since the Nuremberg trials of 1947 🇺🇸 scholar.google.com/scholar_case?c…

☢️#radiology
🥼#nephrology
🏥#publichealth ⚠️#patientsafety
💉#MRIdye
Read 4 tweets
Derm/Rheum Consult 1: 82yoW w/ HTN, breast can, new annular rash. Skin bx eosinophilic lymphocytic infiltrate. Gave 1mg/kg steroids.
ANA+ with centromere pattern, CREST?
==>#UnmaskSx with Steroids when tapering steroids.
==>Deep perivascular infiltrate on bx = Derm IDK!

1/
Derm/Rheum Case 2: 78yoF MGUS,HFpEF, rash on legs. ?purpura. w/u Cryocrit normal , RF+ skin bx C3 in vessel walls, LCV.
Dx: Type II Cryo
Learning Pearl: Retiform purpura "angular stellate rash" pic below and diagram -> VASCULITIS or VASCULOPATHY

#dermtwitter #rheumatology
2/
Derm/Rheum 3: Bullous Rash? DDx: Bullous Lupus vs. Epidermal Bullous Acquisita (EBA) vs. Bullous Pemphigoid
Learning Pearl:
Minimal trauma w/ blisters = EBA, treat with dapsone +/- prednisone
Consult Derm!

3/
Read 7 tweets
CUTANEOUS LUPUS – a #tweetorial/#medthread!!

We all learn about Systemic Lupus Erythematosus (SLE) in medical school, but did you know there are multiple forms #lupus can take in the #skin?

#Meded #FOAMed #dermtwitter #medtwitter #rheumtwitter #dermatologia pc: @dermnetnz
1/
It wasn’t until #dermatology residency I learned about all the subtypes of cutaneous lupus (CLE)! I thought it was all just one disease: SLE. But in reality there are many forms of CLE, each with its own implications on systemic involvement and effect on the patient.
2/
Let’s start with the 3 subtypes:
Acute, Subacute, and Chronic Cutaneous Lupus Erythematosus (ACLE, SCLE, CCLE). CCLE is aka Discoid.
Each subtype "overlaps" with SLE in a different way.

Eg: ACLE overlaps completely with SLE, so they all have SLE! 👇
onlinelibrary.wiley.com/doi/abs/10.111…
3/
Read 17 tweets
It's #tweetorial time! Read on for a #medthread on:

Cutaneous Small Vessel #vasculitis (CSVV)!

#MedEd #FOAMEd #dermtwitter #dermatology #medtwitter #rheumtwitter pc: @dermnetnz
1/
I've heard different ways to organize the vasculitides over the years, but by the far the most common is by vessel size. As a #dermatologist, I see the small vessel vasculitides most often, so we'll focus on that today. Yes, Takayasu's important, but I'll save that for later!
2/
There is a relatively limited list of possible diagnoses with CSVV. I've included the most common below.

The blue I lump together as they are similar, and biopsy results help you differentiate.
The red are the ANCA-associated.
The green are the unique ones.
3/
Read 20 tweets
“Gadolinium-based contrast agents: Stimulators of myeloid-induced renal fibrosis and major metabolic disruptors,“ is now in press—sciencedirect.com/science/articl…

#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
#toxicology
#dermatology
#nephrology
Gadolinium-based “magnetic resonance imaging contrast agent treatment impaired renal function, induced pathologic damage, and increased kidney fibrosis,” sciencedirect.com/science/articl…

#gadolinium
#nephrology
#radiology ☢️
#patientsafety
#publichealth
#toxicology
Read 11 tweets
“Notably, in recently published rodent studies, complete clearance of the brain took up to 6 months after injection of a large amount of” gadolinium-based contrast agents. journals.lww.com/investigativer… @HrsQuiet
#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
“[S]o it can be assumed that the total clearance—if achieved at all—might also take months in humans,” after gadolinium-based contrast administration— journals.lww.com/investigativer… @HrsQuiet
#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
#toxicology
Read 4 tweets
“Despite significant differences in the thermodynamic stability between non-ionic Omniscan and ionic Magnevist, the [#gadolinium ☠️] concentrations were about the same in the brain,” nibib.nih.gov/sites/default/…
#radiology ☢️ #patientsafety #publichealth #neurology 🧠 #dermatology
“Chronic symptoms attributed to [gadolinium-based contrast agent] exposure:” paresthesias, dysesthesias, clouded mentation, skin discoloration, skin changes, skin thickening, bone pain, bone/joint pain, muscle spasms, arthralgia, muscular weakness—nibib.nih.gov/sites/default/…
“Chronic symptoms attributed to [gadolinium-based contrast agent] exposure:” fatigue/asthenia, digestive symptoms, nausea, vomiting, diarrhea. nibib.nih.gov/sites/default/…
#gadolinium #radiology ☢️ #patientsafety #publichealth #neurology 🧠 #dermatology #nephrology #rheumatology
Read 14 tweets

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